Gale Encyclopedia of Psychology clear version in English

average of nine years of treatment by 15 different institu- version of childhood conduct disorder. Antisocial per- tions. Treatments averaged seven months each. sonality disorder is only diagnosed in people over age 18, the symptoms are similar to those of conduct disorder, Studies show that children who are given social and the criteria for diagnosis include the onset of conduct skills instruction decrease their antisocial behavior, espe- disorder before the age of 15. According to the Diagnos- cially when the instruction is combined with some form tic and Statistical Manual of Mental Disorders (DSM- of supportive peer group or family therapy. But the Antisocial personality disorder IV), people with antisocial personality disorder demon- long-term effectiveness of any form of therapy for anti- strate a pattern of antisocial behavior since age 15. social behavior has not been demonstrated. The fact that peer groups have such a strong influence on behavior The adult with antisocial personality disorder dis- suggests that schools that employ collaborative learning plays at least three of the following behaviors: and the mainstreaming of antisocial students with regu- •Fails to conform to social norms, as indicated by fre- lar students may prove most beneficial to the antisocial quently performing illegal acts, and pursuing illegal oc- child. Because the classroom is a natural environment, cupations. learned skills do not need to be transferred. By judi- • Is deceitful and manipulative of others, often in order ciously dividing the classroom into groups and explicitly to obtain money, sex, or drugs. stating procedures for group interactions, teachers can create opportunities for positive interaction between an- • Is impulsive, holding a succession of jobs or resi- tisocial and other students. dences. •Is irritable or aggressive, engaging in physical fights. See also Antisocial personality disorder; Conduct dis- order; Oppositional-defiant disorder; Peer acceptance • Exhibits reckless disregard for safety of self or others, misusing motor vehicles or playing with fire. Further Reading • Is consistently irresponsible, failing to find or sustain Evans, W. H., et al. Behavior and Instructional Management: work or to pay bills and debts. An Ecological Approach. Boston: Allyn and Bacon, 1989. •Demonstrates lack of remorse for the harm his or her Landau, Elaine. Teenage Violence. Englewood Cliffs, NJ: Ju- behavior causes others. lian Messner, 1990. McIntyre, T. The Behavior Management Handbook: Setting An individual diagnosed with antisocial personality Up Effective Behavior Management Systems. Boston: disorder will demonstrate few of his or her own feelings Allyn and Bacon, 1989. beyond contempt for others. This lack of affect is Merrell, K. W. School Social Behavior Scales. Bradon, VT: strangely combined with an inflated sense of self-worth Clinical Psychology Pub. Co., 1993. and often a superficial charm, which tends to mask their Redl, Fritz. Children Who Hate: The Disorganization and inner apathy. Authorities have linked antisocial personal- Breakdown of Behavior Controls. New York: Free Press, ity disorder with abuse, either physical or sexual, during 1965. childhood, neurological disorders (which are often undi- Shoemaker, Donald J. Theories of Delinquency: An Examina- agnosed), and low IQ. Those with a parent with an anti- tion of Explanations of Delinquent Behavior, 2nd ed. New social personality disorder or substance abuse problem York: Oxford UP, 1990. Whitehead, John T. and Steven P. Lab. Juvenile Justice: An In- are more likely to develop the disorder. The antisocially troduction. Cincinnati, OH: Anderson Pub. Co., 1990. disordered person may be poverty-stricken, homeless, a Wilson, Amos N. Understanding Black Adolescent Male Vio- substance abuser, or have an extensive criminal record. lence: Its Prevention and Remediation. Afrikan World In- Antisocial personality disorder is associated with low so- fosystems, 1992. cioeconomic status and urban settings. Treatment Antisocial personality disorder is highly unrespon- Antisocial personality sive to any form of treatment. Although there are med- disorder ications available that could quell some of the symptoms A behavior disorder developed by a small percent- of the disorder, noncompliance or abuse of the drugs pre- age of children with conduct disorder whose be- vents their widespread use. The most successful treat- havior does not improve as they mature. Also ment programs are long-term, structured residential set- known as sociopathy or psychopathy. tings in which the patient systematically earns privileges as he or she modifies behavior. Some form of dynamic About 3% of males and 1% of females develop anti- psychotherapy is usually given along with the behavior social personality disorder, which is essentially the adult modification. The therapist’s primary task is to establish GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 41

Anxiety/Anxiety disorders a relationship with the patient, who has usually had very anxiety disorders is disproportionately intense. Anxious feelings interfere with a person’s ability to carry out nor- few relationships in his or her life and is unable to trust, mal or desired activities. Many people experience stage fantasize, feel, or learn. The patient should be given the fright—the fear of speaking in public in front of large opportunity to establish positive relationships with as many people as possible and be encouraged to join self- groups of people. There is little, if any, real danger posed help groups or prosocial reform organizations. by either situation, yet each can stimulate intense feel- ings of anxiety that can affect or derail a person’s desires See also Antisocial behavior; Conduct disorder; Op- positional-defiant disorder; Peer acceptance ety as a danger signal. In his id-ego-superego scheme of human behavior, anxiety occurs when unconscious sex- Further Reading or obligations. Sigmund Freud described neurotic anxi- Cleckley, Hervey M. The Mask of Sanity. Rev. ed. New York: ual or aggressive tendencies conflict with physical or New American Library; St. Louis: Mosby, 1982. moral limitations. Magid, Ken, and Carole A. McKelvey. High Risk. New York: Anxiety disorders afflict millions of people. Symp- Bantam Books, 1988. toms of these disorders include physiological responses: Winnicott, D. W. Deprivation and Delinquency. New York: a change in heart rate, trembling, dizziness, and tension, Tavistock Publications, 1984. which may range widely in severity and origin. People Further Information who experience generalized anxiety disorder and panic Antisocial and Violent Behavior Branch. Division of Biometry disorders usually do not recognize a specific reason for and Applied Sciences. National Institute of Mental their anxiety. Phobias and obsessive-compulsive disor- Health. 18-105 Parklawn Bldg., 5600 Fishers Lane, ders occur as people react to specific situations or stim- Rockville, MD 20857, (301) 443–3728. uli. Generalized anxiety disorder is characterized by per- vasive feelings of worry and tension, often coupled with fatigue, rapid heart rate, impaired sleep, and other physi- ological symptoms. Any kind of stress can trigger inap- Anxiety/Anxiety disorders propriate, intense responses, and panic attacks can result. People suffering from generalized anxiety experience An unpleasant emotion triggered by anticipation of “free-floating” fears, that is, no specific event or situa- future events, memories of past events, or rumina- tions about the self. tion triggers the response. People keep themselves on guard to ward against unknown dangers. Stimulated by real or imagined dangers, anxiety af- It is believed that generalized anxiety disorder is, at flicts people of all ages and social backgrounds. When least to some extent, inherited, or is caused by chemical the anxiety results from irrational fears, it can disrupt or imbalances in the body. Depending on the severity of the disable normal life. Some researchers believe anxiety is symptoms and the responsiveness of the patient, treat- synonymous with fear, occurring in varying degrees and ment may vary. Often, drugs in the benzodiazepine fami- in situations where people feel threatened by some dan- ly (Valium, Librium, and Xanax) are prescribed. These ger. Others describe anxiety as an unpleasant emotion drugs combat generalized anxiety by relaxing the cen- caused by unidentifiable dangers or dangers that, in real- tral nervous system, thus reducing tension and relaxing ity, pose no threat. Unlike fear, which is caused by realis- muscles. They can cause drowsiness, making them an tic, known dangers, anxiety can be more difficult to iden- appropriate treatment for insomnia. In proper dosages, tify and to alleviate. they can relieve anxiety without negatively affecting thought processes or alertness. Medication is most effec- Rather than attempting to formulate a strict defini- tive when combined with psychological therapies to re- tion of anxiety, most psychologists simply make the dis- duce the risk of recurrence. Behavior therapy is de- tinction between normal anxiety and neurotic anxiety, or signed to help modify and gain control over unwanted anxiety disorders. Normal (sometimes called objective) behaviors by learning to cope with difficult situations, anxiety occurs when people react appropriately to the often through controlled exposures to those situations. situation causing the anxiety. For example, most people Cognitive therapy is designed to change unproductive feel anxious on the first day at a new job for any number thought patterns by learning to examine feelings and dis- of reasons. They are uncertain how they will be received tinguish between rational and irrational thoughts. Relax- by co-workers, they may be unfamiliar with their duties, ation techniques focus on breathing retraining to relax or they may be unsure they made the correct decision in and resolve the stresses that contribute to anxiety. taking the job. Despite these feelings and any accompa- nying physiological responses, they carry on and eventu- Controlling or eliminating the physical symptoms of ally adapt. In contrast, anxiety that is characteristic of anxiety without medication is another method of treatment. 42 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

APGAR SCORING SYSTEM Aphasia Factor 0 points 1 point 2 points Heart rate No heartbeat Under 100 beats per Over 100 beats per minute minute Respiration Not breathing Irregular, with weak cry Regular with strong cry Muscle tone Limp, no movement Limited movement of the Active movement of the limbs limbs Color Completely blue, pale Pink body with blue hands All pink and feet Reflexes No response to being Grimace when poked Cry, cough, or sneeze poked in the nose when poked For example, practiced breathing techniques can slow the breathing, muscle tone, color, and reflexes. Each catego- heart rate. Access to fresh air can ease sweating. Effective ry is given a score between zero and two, with the highest control of such symptoms can be useful in controlling the possible test score totaling ten (a score of 10 is rare, see anxiety itself. Psychotherapy is another method of treat- chart). Heart rate is assessed as either under or over 100 ing generalized anxiety disorder and is used in conjunction beats per minute. Respiration is evaluated according to with drug therapy or in cases where medication proves regularity and strength of the newborn’s cry. Muscle tone ineffective. While there is no definitive cause for the disor- categories range from limp to active movement. Color— der, communicating their feelings to a sympathetic thera- an indicator of blood supply—is determined by how pink pist helps some people reduce their anxiety. the infant is (completely blue or pale; pink body with blue extremities; or completely pink). Reflexes are mea- Further Reading sured by the baby’s response to being poked and range Amen, Daniel G. Change Your Brain, Change Your Life: The from no response to vigorous cry, cough, or sneeze. An Breakthrough Program for Conquering Anxiety, Depres- infant with an Apgar score of eight to ten is considered to sion, Obsessiveness, Anger, and Impulsiveness. New York: be in excellent health. A score of five to seven shows mild Crown Publishing Group, 2000. problems, while a total below five indicates that medical Goodwin, Donald W. Anxiety. New York: Oxford University intervention is needed immediately. Press, 1986. Zimbardo, Philip G. Psychology and Life. 12th ed. Glenview, IL: Scott, Foresman, 1988. Aphasia Apgar score A condition, caused by neurological damage or disease, in which a person’s previous capacity to An indication of a newborn infant’s overall medical understand or express language is impaired. The condition. ability to speak, listen, read, or write may be affect- ed depending on the type of aphasia involved. The Apgar Score is the sum of numerical results In contrast to neurological problems that affect the from tests performed on newborn infants. The tests were physical ability to speak or perform other linguistic devised in 1953 by pediatrician Virginia Apgar (1909- functions, aphasia involves the mental ability to manipu- 1974). The primary purpose of the Apgar series of tests is late speech sounds, vocabulary, grammar, and meaning. to determine as soon as possible after birth whether an There are several different types of aphasia. Each has infant requires any medical attention, and to determine different symptoms and is caused by damage to a differ- whether transfer to a neonatal (newborn infant) intensive ent part of the brain. care unit is necessary. The test is administered one minute after birth and again four minutes later. The newborn in- The great majority of aphasias are caused by dam- fant’s condition is evaluated in five categories: heart rate, age to the left hemisphere of the brain, which is the dom- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 43

Aphasia aphasia is overly concise, in Wernicke’s aphasia it is filled with an abundance of words (logorrhea), but they are words which fail to convey the speaker’s meaning. Even though their pitch and rhythm sound normal, many Wernicke's area of the words are used incorrectly or are made-up words Broca's area with no meaning (aphasic jargon). Besides their speech difficulties, persons with Wernicke’s aphasia also have trouble comprehending language, repeating speech, naming objects, reading, and writing. An interesting ex- ception to their comprehension impairment is their abili- ty to respond readily to direct commands that involve bodily movement, such as “Close your eyes.” Certain types of aphasia—called disconnection aphasias—are caused by damage to the connections of Broca’s or Wernicke’s areas to each other or to other parts of the brain. Conduction aphasia results from damage to the fiber bundles connecting the two language areas and is characterized by fluent but somewhat meaningless speech and an inability to repeat phrases correctly. In transcortical sensory aphasia, the connections between Wernicke’s area and the rest of the brain are severed, but the area itself is left intact. Persons with this condition have trouble under- standing language and expressing their thoughts but can repeat speech without any trouble. Another type of apha- sia, word deafness, occurs when auditory information is Broca’s aphasia results from damage to the frontal lobe of the language-dominant area of the brain. Wernicke’s prevented from reaching Wernicke’s area. Persons affect- aphasia is caused by damage to the temporal lobe of the ed by word deafness can hear sounds of all kinds and un- same language-dominant area. (Electronic Illustrations Group. derstand written language, but spoken language is incom- Reproduced with permission.) prehensible to them, since the auditory signals cannot reach the part of the brain that decodes them. Most types of aphasia are accompanied by some dif- inant language hemisphere for approximately 95 percent ficulty in naming objects. However, when this problem is of right-handed people and 60 to 70 percent of left-hand- the only symptom, the condition is called anomic apha- ed people. Two areas in the left hemisphere—Broca’s sia. Persons with anomic aphasia can comprehend and area and Wernicke’s area—and the pathways connecting repeat the speech of others and express themselves fairly them are especially important to linguistic ability, and well, although they are unable to find some of the words damage to these areas is the most common cause of they need. However, they do poorly when asked to name aphasia. Broca’s area, located in the frontal lobe of the specific objects. Anomic aphasia is caused by left hemi- left hemisphere, is named for the 19th-century French sphere damage that does not affect either Broca’s or physician Paul Broca (1824-1880), an early pioneer in Wernicke’s area. It commonly occurs after a head injury the study of lateralization (the specialized functioning of and also in Alzheimer’s disease. Global aphasia is the right and left sides of the brain). Aphasia resulting caused by widespread damage to the dominant cerebral from damage to this area, called Broca’s aphasia, is char- hemisphere, either left or right. This condition is charac- acterized by slow, labored, “telegraphic” speech, from terized by an almost total loss of all types of verbal abili- which common grammatical function words, such as ty—speech, comprehension, reading, and writing. prepositions and articles, are missing (“I went doctor”). In general, however, comprehension of spoken and writ- It is possible for people suffering from aphasia fol- ten language is relatively unaffected. lowing a stroke or head injury to recover some of their language abilities with the aid of a speech therapist. Wernicke’s area, in the upper rear part of the left However, there is little chance of recovery from severe temporal lobe, is named for Carl Wernicke (1848- cases of aphasia. 1905), who first described it in 1874. Aphasia associated with this area—called Wernicke’s aphasia—differs dra- See also Left-brain hemisphere; Right-brain hemi- matically from Broca’s aphasia. While speech in Broca’s sphere 44 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

Further Reading ents, and advise the school system on methods to best fa- Browning, Elizabeth. I Can’t See What You’re Saying. New cilitate the child’s education. Educational psychologists, York: Coward, McCann & Geoghegan, 1973. by comparison, study the process of education itself; Hughes, Kathy. God Isn’t Finished With Me Yet. Nashville: how people learn and which educational methods and Applied psychology Winston-Derek, 1990. materials are most successful. Applied research in this Howard, David. Aphasia Therapy: Historical and Contempo- field focuses on how to improve teaching, solve learning rary Issues. Hillsdale, NJ: Erlbaum, 1987. problems, and measure learning ability and progress. Educational psychologists may devise achievement tests, evaluate teaching methods, develop learning aids and curricula, and investigate how children of various Applied psychology ages learn. They often serve as researchers and educators at teacher training institutions, in university psychology The area of psychology in which basic theory and departments, and on the staffs of educational research or- research are applied to the actual problems faced by individuals on a daily basis. ganizations. Educational psychologists also work in gov- ernment agencies, business, and the military. Applied psychology can be best understood by com- Applied psychology has many applications in busi- paring it to the area of psychology known as basic psy- ness and industry. Organizational and industrial psychol- chology, which is concerned with answering questions ogists are concerned with the relationships between peo- about behavior through psychological theory and re- ple and their jobs. They study and advise employers in search. Applied psychology utilizes this knowledge to such areas as employee morale, job-related stress, job en- actively intervene in the treatment of individuals with richment, leadership qualities, and the effects of flex mental or emotional disorders, and is also employed in time in productivity. Personnel psychologists screen job business, education, and government. applicants, assess job performance, and recommend em- ployees for promotion. Consumer psychologists study the Approximately two-thirds of American psycholo- preferences and buying habits of consumers as well as gists work in applied fields. Many are involved in clinical their responses to advertising, often working together or counseling psychology, diagnosing and treating indi- with advertising copywriters, public relations experts, viduals with various problems of adjustment. Approxi- and statisticians. They are employed not only by business mately one-third of the psychologists in practice in the but also by government agencies such as the Food and United States today are clinical psychologists, and most Drug Administration and the Federal Trade Commission. people are referred to them for treatment of a wide range of problems, including developmental, medical, and reha- Engineering psychology applies information about bilitative as well as psychiatric. These professionals use a human behavior to the design of machines, tools, jobs, wide range of therapies, ranging from Freudian psycho- and work environments to provide the best possible analysis to Rogerian client-centered therapy to newer match with the abilities and limitations of the human be- cognitive approaches. Clinical psychologists may go into ings who will use them. It is part of a broader area private practice, either alone or in groups, or work in hos- known as human-factors engineering (also called er- pitals or clinics. They may also practice in a variety of gonomics) that has links to anatomy, anthropometry, en- other settings, including community mental-health cen- vironmental medicine, and toxicology. One very specific ters, university medical schools, centers for the mentally work environment that provides the arena for another and physically handicapped, prisons, state institutions specialization is the military. Military psychologists ap- and hospitals, judicial courts, and probation offices. A plying psychological research to the operations of the subfield within clinical psychology is community psy- armed forces are involved in personnel selection, testing, chology, which investigates environmental factors that and training; evaluating morale; analyzing job perfor- contribute to mental and emotional disorders. Health psy- mance; studying social interaction among troops; and chologists deal with the psychological aspects of physical exploring the dynamics of combat situations. Psycholo- illness, investigating the connections between the mind gy has also contributed to the exploration of space in and a person’s physical condition. areas including the selection and training of astronauts; the study of alterations in work-rest cycles; the design of Applied psychology also includes the areas of space vehicles, space suits, and equipment used in space; school and educational psychology. School psycholo- and research on the operational problems of space flight. gists are state certified and work in public school set- tings, often with children who have learning, behavioral, A relatively new specialty is forensic psychology, and emotional problems. They perform individualized which involves the application of psychology to law en- assessments of each child, consult with his or her par- forcement and the judicial system. While some forensic GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 45

Aptitude tests psychologists perform research in academic settings, to the personal unconscious—gathers together and passes on the experiences of previous generations, preserving others work in police departments, participating in offi- traces of humanity’s evolutionary development over time. cer training and assisting in criminal investigations. Forensic psychologists may help create personality pro- Carl Jung began to evolve his theory of archetypes files of criminals; formulate principles for jury selection; hypnotize victims, eyewitnesses, or defendants to en- around 1910 while working with patients at the Burghölzli Mental Hospital. Noting the presence of universal sym- hance their memories; or study the problems involved in bols from religion and mythology in the dreams and fan- eyewitness testimony. Yet another emerging area is pro- tasies of uneducated patients, who would have had no gram evaluation, whose practitioners evaluate the effec- conscious way of learning them, he concluded that these tiveness and cost efficiency of government programs for images belonged to a part of the unconscious not derived the Congressional Budget Office, the General Account- from personal experience. Jung proposed that universal ing Office, and other government offices and agencies. images and ideas can be passed from generation to gener- Like psychologists engaged in research, the majority ation like biological traits, and he formulated the concept of those who practice applied psychology hold Ph.D. de- of the collective unconscious, whose contents become grees in the field. Doctoral programs generally require conscious when called forth by appropriate experiences in completion of a four- to six-year program offered by a one’s life. In formulating his ideas about archetypes, Jung university psychology department. The course of study in- supplemented his clinical observations with a comprehen- cludes a broad overview (including courses in such areas sive study of myths and symbols that later included inves- as statistics, personality theory, and psychotherapy), as tigations into the religions and mythologies of preliterate well as specialization in a particular subfield and comple- peoples in Africa and the southwestern United States. tion of a practicum, internship, and dissertation. Some Jungian archetypes are like prototypes or molds that clinical psychologists hold a Psychology Doctorate each person fills in differently depending on his or her in- (Psy.D.), a degree that was introduced at the University of dividual experience. For example, although the term Illinois in 1968 and is geared exclusively toward the train- “mother” has certain universal connotations that come to ing of clinicians rather than researchers. Offered at univer- mind for most people, the details of this archetype will be sities and at independent, “free-standing” professional different for everyone. For Jung, archetypes were more schools of psychology, the Psy.D. program stresses course than a theoretical construct—his interest in them was pri- work in applied methods of assessment and intervention marily therapeutic. He claimed that his patients improved and eliminates the dissertation requirement. when they understood the ways in which their difficulties were related to archetypes. There is no limit to the num- Further Reading ber of possible archetypes: they are as varied as human Beck, Robert C. Applying Psychology: Critical and Creative experience itself. Many take the form of persons, such as Thinking. 3rd ed. Englewood Cliffs, NJ: Prentice-Hall, 1992. the hero, the child, the trickster, the demon, and the earth Wise, Paula Sachs. The Use of Assessment Techniques by Ap- mother. Others are expressed as forces of nature (sun, plied Psychologists. Belmont, CA: Wadsworth Publishing moon, wind, fire) or animals. They may also occur as sit- Co., 1989. uations, events (birth, rebirth, death), or places. Jung considered four archetypes, in particular, im- portant enough to form separate systems within the per- sonality. These include the persona, the anima and ani- Aptitude tests mus, the shadow, and the self. The persona is a person’s public image, the self he or she shows to others (“per- sona” is derived from the Latin word for mask). The per- See Vocational Aptitude Test sona is necessary for survival, as everyone must play cer- tain roles, both socially and professionally, to get along in society. However, management of the persona can cause emotional difficulties. A common problem occurs Archetype when a person comes to identify too strongly with the persona that he or she has created, a condition that Jung A central concept in the theory of personality de- called inflation. Victims of this problem are often highly veloped by Swiss psychiatrist Carl Jung. successful, accomplished people who have become so preoccupied with projecting a certain image—often for Archetypes are primordial images and symbols professional advancement—that their lives become found in the collective unconscious, which—in contrast empty and alienated. 46 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

The anima and animus are the opposite of the per- ating a machine to recognize objects in photographs sona—they represent a person’s innermost self. They are would seem, at first thought, rather simple. Yet, when hu- also distinguished by gender: the anima is a man’s femi- mans look at a photograph, they do so with expectations nine side, and the animus is a woman’s masculine side. about the limitations of the media. We fill in the missing Artificial intelligence Jung theorized that in order for persons of both sexes to third dimension and account for other missing or incon- understand and respond to each other, each sex had to in- sistent images with our sense of what the real world corporate and be able to express elements of the other, a looks like. To program a computer to make those kinds belief that foreshadowed both the feminist and men’s of assumptions would be a gargantuan task. Consider, movements in the United States by over half a century. for instance, all the information such a computer would The shadow is associated with a person’s animal in- need to understand that the array of images all pressed stincts, the “dark side” that is outside the control of the up against a flat surface actually represent the three-di- conscious personality. However, it is also potentially a mensional world. The human mind is capable of decod- source of spontaneity, creativity, and insight. In contrast ing such an image almost instantaneously. to the anima and animus, the shadow is involved in one’s This process of simulating human thought has led to relationships to persons of the same sex. Perhaps the the development of new ideas in information processing. most important archetype is that of the Self, which orga- Among these new concepts are fuzzy logic, whereby a nizes and unites the entire personality. However, rather computer is programmed to think in broader terms than ei- than combining all the other archetypes or aspects of ther/or and yes/no; expert systems, a group of program- personality, the Self has a dynamic all its own, which ming rules that describe a reasoning process allowing governs both inner harmony and harmony with the exter- computers to adapt and learn; data mining, detecting pat- nal world. It is closely related to the ability of human be- terns in stimuli and drawing conclusions from them; ge- ings to reach their highest potential, a process that Jung netic algorithm, a program that provides for random muta- called individuation, which he considered every person’s tion for the machine to improve itself; and several others. ultimate goal. Recent applications of AI technology include ma- Further Reading chines that track financial investments, assist doctors in di- Hall, Calvin S. and Vernon J. Nordby. A Primer of Jungian agnoses and in looking for adverse interactions in patients Psychology. New York: Mentor, 1973. on multiple medications, and spotting credit card fraud. Hopcke, Robert. A Guided Tour of the Collected Works of C. An Australian scientist working in Japan is attempting to G. Jung. Shambhala; distributed in the U.S. by Random create a silicon brain using newly developed quantum re- House, 1989. sistors. Reported in a 1995 article in Business Week, Hugo de Garis is leading a team of scientists to create a comput- ing system capable of reproducing itself. As Business Week reports, the project will attempt to “not only coax Artificial intelligence silicon circuits into giving birth to innate intelligence but imbue them with the power to design themselves—to con- Computer-based technology intended to replicate the complicated processes of human cognition, in- trol their own destiny by spawning new generations of cluding such complex tasks as reasoning, and ma- ever improving brains at electronic speeds.” This type of chine learning, whereby a man-made device actu- technology is called evolvable hardware. ally incorporates its experiences into new endeav- ors, learning from its mistakes and engaging in cre- Other recent advances in AI have been the creation ative problem solving. of artificial neural systems (ANS) which has been de- scribed as “an artificial-intelligence tool that attempts to The study of artificial intelligence, referred to as AI, simulate the physical process upon which intuition is has accelerated in recent years as advancements in com- based—that is, by simulating the process of adaptive bi- puter technology have made it possible to create more ological learning.” ANS, essentially, is a network of and more sophisticated machines and software pro- computers that are grouped together in ways similar to grams. The field of AI is dominated by computer scien- the brain’s configuration of biological processing lobes. tists, but it has important ramifications for psychologists Even considering all of these advancements, many as well because in creating machines that replicate people are skeptical that a machine will ever replicate human thought, much is learned about the processes the human cognition. Marvin Minsky, a scientist at the human brain uses to “think.” Massachusetts Institute of Technology, states that the Creating a machine to think highlights the complex- hardest thing of all in the creation of artificial intelli- ities and subtleties of the human mind. For instance, cre- gence is building a machine with common sense. GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 47

Applications Art therapy Further Reading tool for children, who often have limited language and Anthes, Gary H. “Great Expectations: Award Winning AI Sci- Art therapy can be a particularly useful treatment entist Raj Reddy . . .” Computer World (3 April 1995): 82. Chartrand, Sabra. “A Split in Thinking among Keepers of Arti- ficial Intelligence.” New York Times (18 July 1993). communications skills. By drawing or visually express- ing their feelings, even if they can’t identify or label the Port, Otis. “Computers That Think Are Almost Here.” Business emotions, younger patients have a starting point from Week (17 July 1995): 68-73. which to address these issues. Art therapy is also valu- Wright, Robert. “Can Machines Think?” Time (25 March able for adolescents and adults who are unable or unwill- 1996): 50-58. ing to verbalize thoughts and feelings. Beyond its use in mental health treatment, art therapy is also employed as an adjunct (or complementary) thera- py to traditional medicine for the treatment of biologically based diseases and conditions. The correlation between mental health and physical health is well documented. Art Art therapy therapy has been used in the healing process to relieve stress and develop coping mechanisms, in an effort to The use of art to express feelings, emotions, and treat both the physical and mental needs of the patient. perceptions through the creation and analysis of vi- sual and other sensory symbols and works. Although art therapy has traditionally centered on visual mediums (paintings, sculptures, drawings, etc.), some mental healthcare providers have broadened the Art therapy, sometimes called expressive art or art definition to include music, film, dance, writing, and psychology, encourages self-discovery and emotional other artistic genres. growth. It is a two-part process, involving both the cre- ation of art and the discovery of its meaning. Rooted in Benefits Sigmund Freud and Carl Jung’s theories of the sub- conscious and unconscious,art therapy is based on the • Self-discovery. At its most successful, art therapy trig- premise that visual symbols and images are the most ac- gers an emotional catharsis (a sense of relief and well- cessible and natural form of communication to the being through the recognition and acknowledgement of human experience. Patients are encouraged to visualize, subconscious feelings). and then create, the thoughts and emotions that they • Personal fulfillment. The creation of a tangible reward can’t express verbally. The resulting artwork is then re- can build confidence and nurture feelings of self-worth. viewed, and its meaning interpreted by the patient. The Personal fulfillment comes from both the creative and analysis of the artwork typically enables a patient to gain the analytical components of the process. some level of insight into their feelings and allows them • Empowerment. Art therapy can help individuals visual- to work through these issues in a constructive manner. ly express emotions and fears that they were never able Art therapy is typically practiced in conjunction with in- to articulate through conventional means, and give dividual, group, or family psychotherapy (or verbal them some sense of control over these feelings. therapy). While a therapist may provide critical guidance • Relaxation and stress relief. Chronic stress can be for these activities, an important feature of effective talk harmful to both mind and body. It can weaken and therapy is that the patient/artist, not the therapist, direct damage the immune system, cause insomnia and de- the interpretation of their artwork. pression, and trigger a host of circulatory problems Some mental health professionals also view art (e.g., high blood pressure, atherosclerosis, and cardiac therapy as an effective diagnostic tool for the identifica- arrhythmia). When used alone or in combination with tion of specific types of mental illness or traumatic other relaxation techniques such as guided imagery, art events. In the late 19th century, French psychiatrists Am- therapy can be a potent stress reliever. brose Tardieu and Paul-Max Simon both published stud- • Symptom relief and physical rehabilitation. Art therapy ies on the visual characteristics of and symbolism in the can also help individuals cope with pain and promote artwork of the mentally ill. They found that there were physiological healing by identifying and working recurring themes and visual elements in the drawings of through anger and resentment issues and other emo- patients with specific types of mental illness. More re- tional stresses. cently, psychiatric literature has explored common See also Music therapy themes and symbols in the artwork of sexual abuse sur- vivors and victims of trauma. Paula Ford-Martin 48 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

Further Reading hand. Projective tests present individuals with ambiguous Ganim, Barbara. Art and healing: using expressive art to heal situations which they must interpret, thus projecting their your body, mind, and spirit. New York: Three Rivers own personalities onto those situations. The best known Assimilation Press, 1999. projective test is the Rorschach Psychodiagnostic Test, or inkblot, test first devised by the Swiss psychologist Her- mann Rorschach in the 1920s. The test subject describes his or her reactions to elaborate inkblots presented on a se- Assessment, psychological ries of ten cards. Responses are interpreted with atten- tion to three factors: what parts or parts of each inkblot the The assessment of personality variables. subject responds to; what aspects of the inkblot are stressed (color, shape, etc.); and content (what the inkblot Psychological assessment is used for a variety of represents to the subject). Another widely used projective purposes, ranging from screening job applicants to pro- test is the Thematic Apperception Test (TAT), developed viding data for research projects. Most assessment meth- at Harvard University in the 1930s. In this test, the subject ods fall into one of three categories: observational meth- is shown a series of pictures, each of which can be inter- ods, personality inventories, or projective techniques. preted in a variety of ways, and asked to construct a story based on each one. Responses tend to reflect a person’s Observational assessment is performed by a trained problems, motives, preoccupations, and interpersonal professional either in the subject’s natural setting (such skills. Projective tests require skilled, trained examiners, as a classroom), an experimental setting, or during an in- and the reliability of these tests is difficult to establish due terview. Interviews may be either structured with a stan- to their subjective nature. Assessments may vary widely dard agenda, or unstructured, allowing the subject to de- among different examiners. Scoring systems for particular termine much of what is discussed and in what order. traits have been fairly reliable when used with the The- Impressions gained from interviews are often recorded matic Apperception Test. using rating scales listing different personality traits. Expectations of the observer, conveyed directly or See also Personality inventory; Rorschach technique through body language and other subtle cues, may influ- ence how the interviewee performs and how the observer Further Reading records and interprets his or her observations. Handbook of Psychological Assessment. New York: Wiley, 1990. Personality inventories consist of questionnaires on Personality and Ability: The Personality Assessment System. which people report their feelings or reactions in certain Lanham, MD: University Press of America, 1994. situations. They may assess a particular trait, such as anxiety, or a group of traits. One of the oldest and best known personality inventories is the Minnesota Multi- phasic Personality Inventory (MMPI), a series of 550 questions used to assess a number of personality traits Assimilation and psychological disturbances for people over age 16. An aspect of adaptation proposed by French psy- The MMPI is scored by comparing the subject’s answers chologist Jean Piaget. to those of people known to have the traits or distur- bances in question. While initially designed to aid in the In the cognitive development theory of Jean Pi- diagnosis of serious personality disorders, the MMPI is aget, assimilation is one of two complementary activities now widely used for persons with less severe problems, involved in adaptation, the process of learning from and as enough data has been collected from this population adjusting to one’s environment. Assimilation consists of to allow for reliable interpretation of test results. One taking in new information and incorporating it into exist- problem with personality inventories is that people may ing ways of thinking about the world. Conversely, ac- try to skew their answers in the direction they think will commodation is the process of changing one’s existing help them obtain their objective in taking the test, ideas to adapt to new information. When an infant first whether it is being hired for a job or being admitted to a learns to drink milk from a cup, for example, she tries to therapy program. Validity scales and other methods are assimilate the new experience (the cup) into her existing commonly used to help determine whether an individual way of ingesting milk (sucking). When she finds that this has answered the test items carefully and honestly. doesn’t work, she then changes her way of drinking milk A projective test gives the subject a greater opportuni- by accommodating her actions to the cup. The dual ty for imaginative freedom of expression than does a per- process of accommodation and assimilation leads to the sonality inventory, where the questions are fixed before- formation and alteration of schemas, generalizations GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 49

Associationism about the world which are formed from past experience taneously (or in rapid succession) become associated with each other. and used to guide a person through new experiences. Ac- cording to Piaget, cognitive development involves the James and John Stuart Mill (father and son philoso- constant search for a balance between assimilation and phers) continued to examine associationism into the accommodation, which he referred to as equilibration. In the context of personality, the term “assimila- 19th century. The elder Mill proposed a mechanistic theory that linked ideas together in “compounds,” espe- tion” has been used by Gordon Allport (1897-1967) to cially through the principle of contiguity. The younger describe the tendency to fit information into one’s own Mill, whose defining metaphor for the association of attitudes or expectations. In the study of attitudes and ideas was “mental chemistry,” differed from his father in attitude change, it means adopting the attitudes of peo- claiming that the mind played an active rather than a ple with whom we identify strongly. passive role in forming associations. He also suggested that a whole idea may amount to more than the sum of Further Reading its parts, a concept similar to that later advocated by Allport, G. Pattern and Growth in Personality. New York: Holt, psychologists of the Gestalt school. Other 19th-century Rinehart, and Winston, 1961. figures known for associationist ideas were Thomas Piaget, Jean, and Bärbel Inhelder. The Psychology of the Child. Browne, who proposed several secondary laws of asso- New York: Basic Books, 1969. ciation, and Alexander Bain (1818-1903), who formu- lated a comprehensive psychological system based on association. Aside from similarity and contiguity, other gov- erning principles have been proposed to explain how Associationism ideas become associated with each other. These in- The view that mental processes can be explained clude temporal contiguity (ideas or sensations formed in terms of the association of ideas. close together in time), repetition (ideas that occur to- gether repeatedly), recency (associations formed re- Advanced primarily by a succession of 18th- and cently are the easiest to remember), and vividness (the 19th-century British philosophers, associationism antici- most vivid experiences form the strongest associative pated developments in the modern field of psychology in bonds). In the 20th century, the clearest heir to associ- a variety of ways. In its original empiricist context, it ationism is behaviorism, whose principles of condi- was a reaction against the Platonic philosophy of innate tioning are based on the association of responses to ideas that determined, rather than derived from, experi- stimuli (and on one’s association of those stimuli with ence. Instead, the associationists proposed that ideas positive or negative reinforcement). Also, like associ- originated in experience, entering the mind through the ationism, behaviorism emphasizes the effects of envi- senses and undergoing certain associative operations. ronment (nurture) over innate characteristics (nature). Association appears in other modern contexts as well: The philosopher John Locke (1632-1704) intro- the free association of ideas is a basic technique in the duced the term “association of ideas” in the fourth edi- theory and practice of psychoanalysis, and association tion of his Essay Concerning Human Understanding plays a prominent role in more recent cognitive theo- (1700), where he described it as detrimental to rational ries of memory and learning. thought. George Berkeley (1685-1753), an Irish bishop, applied associationist principles to visual depth percep- Further Reading tion,arguing that the capacity to see things in three di- Locke, John. An Essay Concerning Human Understanding. mensions is the result of learning, not of innate ability. Buffalo: Prometheus Books, 1995. The British physician David Hartley (1705-1757) also Russell, Bertrand. A History of Western Philosophy. New York: dealt with the biological implications of associationism, Simon and Schuster, 1945. formulating a neurophysiological theory about the trans- Schultz, D. P. A History of Modern Psychology. 3rd ed. New mission of ideas and also describing physical activity in York: Academic Press, 1981. terms of association (a concept that anticipated subse- quent principles of conditioning). Hartley also devel- oped a comprehensive theory of associationism that en- compassed memory, imagination, dreams, and morali- Attachment ty. The Scottish philosopher David Hume (1711-1776) proposed the principles of similarity and contiguity, as- An emotional bond between an infant or animal serting that ideas that are similar or experienced simul- and its caregiver, contributing to the infant or ani- 50 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

mal’s experience of safety, comfort, and security fear, but then, having been reassured, it would begin to while in the caregiver’s presence and distress when explore the foreign object. Human infants, too, are much temporarily separated. more likely to react with fear to unknowns if a mother is Attachment not in the vicinity. With a mother present, however, an Many developmental psychologists view attach- infant is much more exploratory—even if the mother is ment—the special relationship between infant and care- not within sight but nearby. giver—as an important building block for later relation- Bowlby became one of the first to map out stages of ships and adult personality. Since attachment plays a attachment, addressed in his writings, including his 1980 central role in theories of social and emotional develop- book, Attachment and Loss. Bowlby suggested that from ment, the scientific study of attachment has remained in birth until about the age of three months, babies are in the forefront of developmental psychology for the past the initial pre-attachment phase. Here, infants simply several decades. need to be held and demonstrate no preference for who John Bowlby,a psychoanalytically trained clini- does the holding. The next phase, attachment-in-the- cian, developed modern attachment theory in the 1950s making phase, takes place from three to four months and as a variant of object-relations, which was a variant of is marked by an infant’s emerging preference to be held Freud’s theory that the infant’s tie to the mother is the by familiar figures, although it is important to note that cornerstone of adult personality. the figure does not necessarily have to be the mother. Ac- Bowlby integrated a number of approaches into his cording to Bowlby, the final stage of attachment is the theory, including systems and evolutionary theories to clear-cut attachment phase. Beginning at about six formulate a modern attachment theory. months, this phase features an infant’s clear insistence on its mother or its primary caregiver. Before widespread acceptance of Bowlby’s theory, psychologists viewed attachment as a secondary drive, Mary Ainsworth,a prominent researcher in attach- derived from primary drives like hunger. It was thought ment and an associate of Bowlby’s, devised a test to mea- that attachment to the mother occurred because she sup- sure the type and degree of attachment a child feels for plied food and became the object of the infant’s attach- his mother. The test, called the Ainsworth Strange Situa- ment through association with feeding and the reduction tion test, involves a mother leading her child into a of other primary needs. Prior to Bowlby’s theory, behav- strange room, which the child is free to explore with the iorist psychologists theorized that the need for attach- mother present. A stranger then enters the room and the ment arose from an infant’s physical needs for food and mother leaves. If the infant becomes distressed, the warmth, both of which were provided by the mother. stranger will try and console her. The mother then returns They believed that a baby’s preference for the mother and the stranger leaves. In another scenario, the mother was the result of conditioning. A child was thought to be leaves again after the stranger returns. Finally, the mother overly attached if crying and clingy behavior occurred returns for good and the stranger leaves. Based on the in- frequently. fants’ response to their mothers’ return, children are la- beled “securely attached,” “avoidant,” or “ambivalent.” Research in the 1950s, however, cast these theories into doubt. One of the most famous research studies in Psychologists believe that attachment serves to help this area was performed by Harry Harlow. He placed children begin exploring the world. As the above studies infant monkeys in a cage with two surrogate mother show, if presented with a strange situation, an infant will dolls: one made of wire holding a bottle of milk and the either avoid or engage in exploration, chiefly dependent other made of soft cloth. According to the behaviorist upon whether an attachment figure is present. Addition- view, the monkey should have developed an attachment ally, it has been shown that lack of attachment in early to the wire mother because she was the source of food. life can have a negative impact on exploratory propensity But the infant monkeys developed attachments to the in later life. In 1971, researchers separated a group of cloth mothers, suggesting that the need for comfort and monkeys from their mothers for six days and then ana- warmth are more important, or more psychologically in- lyzed their behaviors two years later in comparison to a grained, than the need for food. control group that had not undergone separation. The group that had been separated was observed to be far Later experiments with monkeys also revealed the more reticent in exploratory behaviors than the control effects secure attachments had on infants. In one experi- group. Still other studies indicate that cognitive function- ment, strange foreign objects were introduced to a cage ing in children is enhanced among “securely attached” with an infant monkey. When alone, the monkey would (according to the Ainsworth scale) infants. react with fear. When the cloth mother was present, however, the infant would first retreat to the mother in See also Behaviorism; Stranger anxiety GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 51

Attention Further Reading Attention deficit/ Karen, Robert.Becoming Attached: Unfolding the Mysteries of the Infant-Mother Bond and Its Impact on Later Life. hyperactivity disorder New York: Warner Books., 1994. Thompson, Andrea. “The Affection Factor.” Working Mother (ADHD) (April 1995): 63. Disorder characterized by attentional deficit and/or Wise, Nicole. “What’s in Passion?” Parenting (May 1993): 131. hyperactivity—impulsivity more severe than ex- pected for a developmental age. Attention deficit/hyperactivity disorder (ADHD) refers to a combination of excessive motor restlessness, Attention difficulty in controlling or maintaining attention to rele- Selective concentration or focus on a particular vant events, and impulsive responding that is not adap- stimulus. tive. Children and adults experience the symptoms of ADHD in most areas of their life. It affects their perfor- Attention describes the focusing of perceptive mance in school or at work, depending on their age, and awareness on a particular stimulus or set of stimuli that it affects them socially. In some cases, however, ADHD results in the relative exclusion of other stimuli and is sufferers experience the disorder in only one arena, such often accompanied by an increase in the readiness to re- as a child who may be hyperactive only in school, or an ceive and to respond to the stimulus or set of stimuli in- adult who finds it impossible to concentrate during meet- volved. A state of attention may be produced initially in ings or while socializing with friends after work. Particu- many ways, including as a conscious, intentional deci- larly stressful situations, or those requiring the sufferer sion, as a normal function of social interaction, or as a to concentrate for prolonged periods of time, often will reaction to an unexpected event. In any case, attention is exacerbate a symptom or a series of symptoms. a fundamental component of learning. There is evidence Studies indicate that ADHD affects 3-5% of all chil- that very young human infants have an innate ability and dren. For some children hyperactivity is the primary fea- inclination to attend to, however briefly, particular in- ture of their ADHD diagnosis. These children may be stances of auditory or visual stimulation. Children often unable to sit quietly in class. They may fidget in their demonstrate the effects of their attention in the form of chairs, sharpen their pencils multiple times, flip the cor- apparent misperceptions. For example, the relative size ners of the pages back and forth, or talk to a neighbor. of objects near the center of a child’s visual stimulus On the way up to the teacher’s desk they may take sever- field is regularly overestimated by the child. In human al detours. adults, generally, attention seems to be directly related to Most children with ADHD have both attentional and the novelty, incongruity, complexity, or personal signifi- hyperactivity-impulsivity components, and so they may cance of the situation. As situations become increasingly experience difficulties regulating both attention and ac- familiar or similar to situations previously experienced tivity. Although many children who do not have ADHD by an individual, the actions of that individual become seem periodically inattentive or highly active, children increasingly routine, and the individual becomes less at- with ADHD experience these difficulties more severely tentive. There are distinct and measurable neurological than others at the same developmental level. Moreover, and physiological, bioelectric and biochemical aspects these difficulties interfere with age-appropriate behav- and correlates of attention, and the capacity to achieve or ioral expectations across settings such as home, play- to maintain a state of attention may be limited by a num- ground, and school. ber of mental or physical dysfunctions. In psychology, the term “attention span” is used Psychologists have not always used the label ADHD technically and specifically to mean the number of sepa- to describe this constellation of behaviors. In the 1950s rate stimulus elements, or the amount of stimulus materi- and 60s, children exhibiting these symptoms were either al, that can be perceived and remembered after a brief diagnosed as minimally brain damaged or labeled as be- presentation. In popular usage, the term attention span is havior problems. The fourth edition of the Diagnostic used to mean the amount of time that can be continuous- and Statistical Manual (DSM-IV), which is used to clas- ly spent in a state of attention. sify psychiatric disorders, describes ADHD as a pattern of inattention and/or impulsivity-hyperactivity more se- Further Reading vere than expected for the child’s developmental level. Hans, James. The Mysteries of Attention. Albany: SUNY Press, The symptoms must be present before age seven, al- 1993. though diagnosis is frequently made only after the disor- 52 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

ADHD affects people throughout their lives.This man is performing memory-improving exercises to overcome his attention Attention deficit/hyperactivity disorder (ADHD) deficit difficulties. (AP/Wide World Photos. Reproduced with permission.) der interferes with school activities. Symptoms must be (e) appearing to be “constantly on the go,” or (f) exces- present in at least two settings, and there must be clear sive talking. Impulsivity may be related to hyperactive evidence of interference with academic, social, or occu- behavior and may be manifest as (a) impatience or blurt- pational functioning. Finally, the symptoms must not be ing out answers before the question has been finished, due to other neuropsychiatric disorders such as perva- (b) difficulty in waiting for one’s turn, and (c) frequent sive developmental disorder, schizophrenia or other interruptions or intrusions. Impulsive children frequently psychoses, or anxiety disorder or other neuroses. talk out of turn or ask questions seemingly “out of the blue.” Their impulsivity may also lead to accidents or en- Inattention may be evident in (a) failing to attend gaging in high risk behavior without consideration of the closely to tasks or making careless errors, (b) having dif- consequences. According to the DSM-IV, six or more of ficulty in persisting with tasks until they are completed, these symptoms must persist for six months or more for (c) appearing not to be listening, (d) frequently shifting a diagnosis of ADHD with hyperactivity-impulsivity as a tasks or activities, (e) appearing disorganized, (f) avoid- major component. ing activities that require close or sustained attention, (g) losing or damaging items by not handling them with suf- The DSM-IV recognizes subtypes of ADHD. The ficient care, (h) being distracted by background noises or most prevalent type is the Combined Type, in which in- events, or (i) being forgetful in daily activities. Accord- dividuals show at least six of the symptoms of inatten- ing to the DSM-IV, six or more of these symptoms must tion as well as of hyperactivity or impulsivity. The Pre- persist for six months or more for a diagnosis of ADHD dominantly Inattentive Type and the Predominantly Hy- with inattention as a major component. peractive-Impulsive type are distinguished by which of the major pattern of symptoms predominate. Hyperactivity may be seen as (a) fidgety behavior or difficulty sitting still, (b) excessive running or climbing It is important that a careful diagnosis be made be- when not appropriate, (c) not remaining seated when fore proceeding with treatment, especially with medica- asked to, (d) having difficulty enjoying quiet activities, tion. Often symptoms of inattention or hyperactivity may GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 53

cause parents to seek professional help, but these symp- show some reduced metabolism in certain areas (pre- Attention deficit/hyperactivity disorder (ADHD) toms may not necessarily indicate the presence of frontal and premotor cortex) in ADHD adults, but find- ADHD. Paul Dworkin, a physician with special interests ings on younger patients are less clear. One complica- in school failure, reports that out of 245 children referred tion in conducting these imagining studies is the neces- for evaluation due to parental or school concerns about sity for patients to remain still for a period of time, inattention, impulsivity, or overactivity, only 38% re- something that is, of course, difficult for ADHD chil- ceived a diagnosis of ADHD, although almost all (91%) dren to do. were diagnosed with some kind of academic problem. Treatment Who gets ADHD? Treatment for ADHD takes two major forms: treat- Boys outnumber girls by at least a factor of four; ing the child and treating the environment. Pharmaco- studies have found prevalence ranging from four to nine logical treatment can be effective in many cases. Stimu- times as many boys with ADHD compared to girls. The lant medications (Ritalin/methylphenidate, Dexedrine/ family members (first degree relatives) of children with dextroamphetimine, and Cylert/magnesium pemoline) ADHD are more likely to have the disorder, as well as a have positive effect in 60-80% of cases and are the most higher prevalence of mood and anxiety disorders, learn- common type of drugs used for ADHD. The benefits in- ing disabilities, and substance abuse problems. Children clude enhancement of attention span, decrease in impul- who have a history of abuse or neglect, multiple foster sivity and irrelevant behavior, and decreased activity. placements, infections, prenatal drug exposure, or low Vigilance and discrimination increase and handwriting birth weight are also more likely to have ADHD. Al- and math skills frequently improve. These gains are most though there is no definitive laboratory test for ADHD striking when pharmacological treatment is combined nor a distinctive biological marker, children with ADHD with educational and behavioral interventions. do have a higher rate of minor physical anomalies than Stimulant medications, however, may have side ef- the general population. fects that may make them inappropriate choices. These Children may develop problems because of the con- side effects include loss of appetite, insomnia, mood dis- sequences of ADHD. If the causes of a child’s disruptive turbance, headache, and gastro-intestinal distress. Tics or inattentive behavior are not understood, the child may may also appear and should be monitored carefully. Psy- be punished, ridiculed, or rejected, leading to potential re- chotic reactions are among the more severe side effects. actions in the areas of self-esteem, conduct, academic per- There is some evidence that long-term use of stimulant formance, and family and social relations. A child who medication may interfere with physical growth and feels that he or she is unable to perform to expectations no weight gain. These effects are thought to be ameliorated matter what type of effort is put forth may begin to feel by “medication breaks” over school vacations and week- helpless or depressed. Often, the reaction can exacerbate ends, and the like. the inattention or hyperactivity or diminish the child’s ca- When stimulant medications are not an appropriate pacity to compensate, and a vicious cycle can develop. choice, non-stimulants or tricyclic antidepressants may The course of the disorder may vary. For many be prescribed. The use of tricyclic antidepressants, espe- ADHD children, symptoms remain relatively stable into cially, has to be monitored carefully due to possible car- the early teen years and abate during later adolescence diac side effects. Combined pharmacologic treatment is and adulthood. About 30-40% of cases persist into the late used for patients who have ADHD in addition to another teens. Some individuals continue to experience all of their psychiatric disorder. symptoms into adulthood and others retain only some. It is important that drug treatment not be used ex- clusively in the management of ADHD. Each child should have an individual educational plan that outlines What causes ADHD? modifications to the regular mode of instruction that The exact cause of ADHD is not known. The in- will facilitate the child’s academic performance. Teach- creased incidence of the disorder in families suggests a ers need to consider the needs of the ADHD child when genetic component in some cases. Brain chemistry is giving instructions, making sure that they are well paced implicated by the actions of the medications that reduce with cues to remind the child of each one. They must ADHD symptoms, suggesting that there may be a dys- also understand the origins of impulsive behavior—that function of the norepinephrine and dopamine systems. the child is not deliberately trying to ruin a lesson or ac- Brain imagining techniques have been used with mixed tivity by acting unruly. Teachers should be structured, success. Positron emission tomography (PET) scans comfortable with the remedial services the child may 54 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

need, and able to maintain good lines of communication with the parent. Attitude and behavior Special assistance may not be limited to educational Attitude is a feeling, belief, or opinion of approval settings. Families frequently need help in coping with or disapproval towards something. Behavior is an Attitude and behavior the demands and challenges of the ADHD child. Inatten- action or reaction that occurs in response to an event or internal stimuli (i.e., thought). tion, shifting activities every five minutes, difficulty completing homework and household tasks, losing things, interrupting, not listening, breaking rules, con- People hold complex relationships between attitudes stant talking, boredom, and irritability can take a toll on and behavior that are further complicated by the social any family. factors influencing both. Behaviors usually, but not al- ways, reflect established beliefs and attitudes. For exam- Support groups for families with any ADHD mem- ple, a man who believes strongly in abstinence before ber are increasingly available through school districts marriage may choose to remain a virgin until his wed- and health care providers. Community colleges frequent- ding night. Under other circumstances, that same man ly offer courses in discipline and behavior management. may engage in premarital sex despite his convictions Counseling services are available to complement any after being influenced by social messages that his mas- type of pharmacological treatment that the family ob- culinity is dependent on sexual activity. tains for its member. There are also a number of popular Ideally, positive attitudes manifest well-adjusted be- books that are informative and helpful. Some of these are haviors. However, in some cases healthy attitudes may re- listed below. sult in harmful behavior. For example, someone may re- main in an abusive and potentially deadly domestic situa- Doreen Arcus, Ph.D. tion because they hold negative attitudes towards divorce. Behavior can be influenced by a number of factors Further Reading beyond attitude, including preconceptions about self and Barkley, R.A. Attention Deficit Hyperactivity Disorder: A others, monetary factors, social influences (what peers Handbook for Diagnosis and Treatment. New York: Guil- and community members are saying and doing), and dord Press, 1990. convenience. Someone may have strong convictions Hallowell, E.M. and J.J. Ratey. Driven to Distraction: Recog- about improving the public school system in their town, nizing and Coping with Attention Deficit Disorder from but if it means a hefty increase to their property taxes, Childhood through Adulthood. New York: Simon and they may vote against any improvements due to the po- Schuster, 1994. tential for monetary loss. Or, they may simply not vote at Manuzza, S., R.G. Klein, A. Bessler, P. Malloy, and M. La- all because their polling place is too far from their home, Padula. “Adult Outcome of Hyperactive Boys: Education- or the weather is bad on election day. al Achievement, Occupational Rank, and Psychiatric Sta- Studies have demonstrated that, in some cases, tus.” Archives of General Psychiatry, 50, (1993): 565-76. pointing out inconsistencies between attitudes and be- Weiss, G. Attention Deficit Hyperactivity Disorder. Philadel- havior can redirect the behavior. In the case of the school phia: W.B. Saunders, 1992. supporter, showing that their actions (i.e., not voting, not Wender, P. The Hyperactive Child, Adolescent, and Adult: At- attending parent-teacher organization meetings) are tention Deficit Disorder through the Lifespan. New York: Oxford University Press, 1987. harming rather than helping efforts to improve education Wilens, T.E. and J. Biederman. “The Stimulants.” Psychiatric in their town may influence them to reevaluate their be- Clinics of North America. D. Shafer, ed. Philadelphia: havior so that it reflects their attitudes. W.B. Saunders, 1992. For those in need of psychological treatment, there Zametkin, A.J. and J.L. Rappaport. “Neurobiology of Attention are several treatment approaches that focus on changing Deficit Disorder with Hyperactivity: Where Have We attitudes in order to change behavior. Cognitive therapy Come in 50 Years?” Journal of the American Academy of and cognitive-behavior therapy are two of those tech- Child and Adolescent Psychiatry 26, (1987): 676-86. niques. Cognitive therapy attempts to change irrational Further Information ways of thinking. Cognitive-behavioral therapy tries to Attention Deficit Disorder Association. P.O. Box 972, Mentor, correct the resulting inappropriate behavior. OH 44061, (800) 487–2282. CHADD (Children and Adults with Attention Deficit Disor- Changing attitudes to change behavior der). 499 NW 70th Ave., Suite 308, Plantation, FL 33317, (305) 587–3700 (A national and international non-profit Attitude and behavior are woven into the fabric of organization for children and adults with ADHD). daily life. Research has shown that individuals register GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 55

Attitudes and attitude change an immediate and automatic reaction of “good” or “bad” the behavior of their peers can have a significant impact. Sometimes this peer pressure factor can be used to an ad- towards everything they encounter in less than a second, vantage. One research study found that antismoking cam- even before they are aware of having formed an attitude. paigns targeted at teenagers can have a higher success Advertising, political campaigns, and other persuasive rate when adolescent peers are used as instructors. media messages are all built on the premise that behavior follows attitude, and attitude can be influenced with the right message delivered in the right way. Paula Ford-Martin The fields of social and behavioral psychology have researched the relationship between attitude and behav- ior extensively. The more psychologists can understand Byrne, Donn and Robert A. Baron. Social psychology. 8th edi- the relationship between attitude and behavior and the tion. Boston, MA: Allyn & Bacon, Inc., 1997. factors that influence both, the more effectively they can Further Reading treat mental disorders, and contribute to the dialogue on Eagly, Alice and Shelly Chaiken. Dawn Youngblood, ed. The important social problems such as racism, gender bias, psychology of attitudes. Forth Worth, TX: Harcourt Brace Jovanovich College Publishers, 1993. and age discrimination. Kelly, George. The psychology of personal constructs. 2 vols. The concept of “social marketing” combines cogni- New York: Norton, 1955. tive-behavioral components of psychology with social science and commercial marketing techniques to encour- age or discourage behaviors by changing the attitudes that cause them. It is also a key part of public health edu- cation initiatives, particularly in the case of preventive Attitudes and attitude change medicine. Campaigns promoting positive attitudes to- An attitude is a predisposition to respond cogni- wards prenatal care, abstinence from drug use, smoking tively, emotionally, or behaviorally to a particular cessation, sunscreen use, organ donations, safe sex, can- object, person, or situation in a particular way. cer screening, and other healthcare initiatives are all ex- amples of social marketing in action. In effect, social Attitudes have three main components: cognitive, af- marketing is “selling” attitudes and beliefs and ideally fective, and behavioral. The cognitive component concerns influencing associated behavior. one’s beliefs; the affective component involves feelings and evaluations; and the behavioral component consists of ways of acting toward the attitude object. The cognitive as- Changing behavior to influence attitudes pects of attitude are generally measured by surveys, inter- In 1955, clinical psychologist and educator George views, and other reporting methods, while the affective Kelly introduced his psychology of personal constructs. components are more easily assessed by monitoring physi- Kelly’s constructs were based on the idea that each indi- ological signs such as heart rate. Behavior, on the other vidual looks at the world through his or her own unique hand, may be assessed by direct observation. set of preconceived notions about it (i.e., constructs). Behavior does not always conform to a person’s feel- These constructs change and adapt as the individual is ings and beliefs. Behavior which reflects a given attitude exposed to new and different situations. At the heart of may be suppressed because of a competing attitude, or in Kelly’s theory is the idea that individuals can seek new deference to the views of others who disagree with it. A experiences and practice and adapt new behaviors in classic theory that addresses inconsistencies in behavior order to change their attitudes (or constructs) towards the and attitudes is Leon Festinger’s theory of cognitive dis- world. He recommended that therapists encourage their sonance, which is based on the principle that people pre- patients to try out new behaviors and coping strategies; fer their cognitions, or beliefs, to be consistent with each he and others that followed frequently found that pa- other and with their own behavior. Inconsistency, or disso- tients would adapt these useful new behavior patterns nance, among their own ideas makes people uneasy and subsequently change their attitudes. enough to alter these ideas so that they will agree with When behavior is inconsistent with attitude, it is each other. For example, smokers forced to deal with the sometimes a result of social or peer pressure. While opposing thoughts “I smoke” and “smoking is dangerous” adult behavior generally follows from held attitudes, for are likely to alter one of them by deciding to quit smok- children, attitudes are often shaped by observed behavior. ing, discount the evidence of its dangers, or adopt the view From a very young age, children copy the actions of oth- that smoking will not harm them personally. Test subjects ers and, to a degree, build their attitudes and beliefs from in hundreds of experiments have reduced cognitive disso- this learned behavior. As children grow into adolescence, nance by changing their attitudes. An alternative explana- 56 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

tion of attitude change is provided by Daryl Bem’s self- the greater one’s intelligence, the more willing one is to perception theory, which asserts that people adjust their consider differing points of view. On the other hand, attitudes to match their own previous behavior. people with superior intelligence may be less easily per- suaded because they are more likely to detect weakness- Attitudes are formed in different ways. Children ac- es in another person’s argument. There is, however, evi- Attraction, interpersonal quire many of their attitudes by modeling their parents’ dence of a direct link between self-esteem and attitude attitudes. Classical conditioning using pleasurable stim- change. People with low self-esteem are often not atten- uli is another method of attitude formation and one widely tive enough to absorb persuasive messages, while those used by advertisers who pair a product with catchy music, with high self-esteem are too sure of their own opinions soothing colors, or attractive people. Operant condition- to be easily persuaded to change them. The most easily ing, which utilizes rewards, is a mode of attitude forma- persuaded individuals tend to be those with moderate tion often employed by parents and teachers. Attitudes are levels of self-esteem, who are likely to pay a reasonable also formed through direct experience. It is known, in fact, amount of attention to what those around them say and that the more exposure one has toward a given object, remain open enough to let it change their minds. whether it is a song, clothing style, beverage, or politician, the more positive one’s attitude is likely to be. The medium of persuasion also influences attitude change (“the medium is the message”). Face-to-face One of the most common types of communication, communication is usually more effective than mass com- persuasion, is a discourse aimed at changing people’s at- munication, for example, although the effectiveness of titudes. Its success depends on several factors. The first any one component of communication always involves of these is the source, or communicator, of a message. To the interaction of all of them. The effects of persuasion be effective, a communicator must have credibility based may take different forms. Sometimes they are evident on his or her perceived knowledge of the topic, and also right away; at other times they may be delayed (the so- be considered trustworthy. The greater the perceived called “sleeper effect”). In addition, people may often similarity between communicator and audience, the change their attitudes only to revert over time to their greater the communicator’s effectiveness. This is the original opinions, especially if their environment sup- principle behind politicians’ perennial attempts to por- ports the initial opinion. tray themselves in a folksy, “down home” manner to The information-processing model of persuasion, de- their constituency. This practice has come to include dis- veloped by psychologist William McGuire, focuses on a tinguishing and distancing themselves from “Washing- chronological sequence of steps that are necessary for suc- ton insiders” who are perceived by the majority of the cessful persuasion to take place. In order to change listen- electorate as being different from themselves. ers’attitudes, one must first capture their attention, and the In analyzing the effectiveness of the persuasive mes- listeners must comprehend the message. They must then sage itself, the method by which the message is present- yield to the argument, and retain it until there is an oppor- ed is at least as important as its content. Factors influenc- tunity for action—the final step in attitude change. ing the persuasiveness of a message include whether it presents one or both sides of an argument; whether it Further Reading states an implicit or explicit conclusion; whether or not it Chapman, Elwood N. Attitude: Your Most Priceless Posses- provokes fear; and whether it presents its strongest argu- sion. 2nd ed. Los Altos, CA: Crisp Publications, 1990. ments first or last. If the same communicator were to Eiser, J. Richard Social Psychology: Attitudes, Cognition, and present an identical message to two different groups, the Social Behaviour. New York: Cambridge University Press, 1986. number of people whose attitudes were changed would Zimbardo, Philip G. The Psychology of Attitude Change and still vary because audience variables such as age, sex, Social Influence. Philadelphia: Temple University Press, and intelligence also affect attitude change. Many stud- 1991. ies have found women to be more susceptible to persua- sion than men, but contrasting theories have been ad- vanced to account for this phenomenon. Some have at- tributed it to the superior verbal skills of females which may increase their ability to understand and process ver- Attraction, interpersonal bal arguments. Others argue that it is culturally deter- A favorable attitude toward, or a fondness for, an- mined by the greater pressure women feel to conform to other person. others’ opinions and expectations. The effect of intelligence on attitude change is in- Both personal characteristics and environment play conclusive. On one hand, it has been hypothesized that a role in interpersonal attraction. A major determinant of GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 57

Attribution theory attraction is propinquity, or physical proximity. People equivalent to their own. According to another theory, a person will choose a partner who will enhance his or her who come into contact regularly and have no prior nega- own self-image or persona. Researchers generally ac- tive feelings about each other generally become attracted to each other as their degree of mutual familiarity and knowledge a specific set of courting or flirting behaviors, comfort level increases. The situation in which people employed by both sexes to attract each other. Initially, first meet also determines how they will feel about each both men and women use varied repertoires of body lan- other. One is more likely to feel friendly toward a person first encountered in pleasant, comfortable circumstances. guage to signal interest and/or availability. Men may stretch, exaggerate ordinary motions (such as stirring a drink), or engage in preening motions, such as smooth- People are generally drawn to each other when they ing the hair or adjusting neckties, and younger men often perceive similarities with each other. The more attitudes affect a swagger. Women draw attention to themselves and opinions two people share, the greater the probabili- by tossing or playing with their hair, tilting their heads, ty that they will like each other. It has also been shown raising their eyebrows, giggling, or blushing. The first that disagreement on important issues decreases attrac- connection is generally made through eye contact, often tion. One of the most important shared attitudes is that an intent gaze which is then lowered or averted. If the liking and disliking the same people creates an especial- eye contact is positively received, a smile often follows ly strong bond between two individuals. The connection and a conversation is initiated. between interpersonal attraction and similar attitudes is complex because once two people become friends, they Conversations initiated by romantic attraction are begin to influence each other’s attitudes. generally light and often include laughter. If the attrac- tion progresses, the next step is casual touching in in- Personality type is another determinant of interper- nocuous areas such as the shoulder, wrist, or forearm. sonal attraction. In areas involving control, such as dom- The final step in the initial romantic attraction is known inance, competition, and self-confidence, people tend to as mirroring or body synchrony, which is a matching of pair up with their opposites. Thus, for example, the com- nonverbal body language. With bodies aligned and fac- plementary pairing of a dominant person with a submis- ing each other, the couple begins to move in tandem, sive one. People gravitate to others who are like them- leaning toward each other, crossing their legs, or tilting selves in terms of characteristics related to affiliation, their heads. By these actions, the couple mutually trans- including sociability, friendliness, and warmth. Another mit the messages that they like and are like each other. important factor in interpersonal attraction, especially This mirroring activity is not confined to romantic rela- during the initial encounter, is that of physical appear- tionships. Infants begin to mirror adult behavior shortly ance, even among members of the same sex. Each cul- after birth, and the technique is consciously practiced by ture has fairly standard ideas about physical appearance therapists, salespeople, and others whose work depends that serve as powerful determinants in how we perceive on establishing a sense of closeness with others. Gener- character. Kindness, sensitivity, intelligence, modesty, ally, the adoption of each other’s postures may be seen in and sociability are among those characteristics that are virtually any grouping of individuals who feel comfort- often attributed to physically attractive individuals in re- able with and are close to each other. search studies. In one study, attractive job applicants (both male and female) were given markedly preferential Further Reading treatment by prospective employers compared with Berscheid, Ellen. Interpersonal Attraction. 2nd ed. Reading, equally qualified candidates who were less attractive. MA: Addison-Wesley, 1978. There is also evidence that physical appearance has a Bull, Ray. The Social Psychology of Facial Appearance. New greater role in the attraction of males to females than York: Springer-Verlag, 1988. vice versa. Behavior, as well as appearance, influences interpersonal attraction. No matter what the circum- stances are, behavior is often seen as reflecting a per- son’s general traits (such as kindness or aggression) rather than as a response to a specific situation. Attribution theory The type of interpersonal attraction that has particu- An area of cognitive therapy that is concerned with lar interest to most people is attraction to the opposite how people explain the causes of behavior, both sex. To a certain extent, romantic attraction is influenced their own and those of others. by evolutionary considerations: the survival of the species. Some experts claim that when people select po- A major concept in the study of attribution theory is tential mates, they look for someone whose status, physi- locus of control:whether one interprets events as being cal attractiveness, and personal qualities are roughly caused by one’s own behavior or by outside circum- 58 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

stances. A person with an internal locus of control, an edly; and distinctiveness is concerned with whether the “internal,” for example, will believe that her perfor- behavior occurs in other, similar, situations. For exam- mance on a work project is governed by her ability or by ple, if a friend consistently fails to repay a loan, an inter- how hard she works. An “external” will attribute success nal attribution may be ascribed. or failure by concluding that the project was easy or Authoritarian personality hard, the boss was helpful or unhelpful, or some other Further Reading rationale. In general, an internal locus of control is asso- Douglas, Tom. Scapegoats: Transferring Blame. New York: ciated with optimism and physical health. People with an Routledge, 1995. Hewstone, Miles, ed. Attribution Theory: Social and Function- internal locus of control also tend to be more successful al Extensions. Oxford, England: B. Blackwell, 1983. at delaying gratification. Lamb, Sharon. The Trouble with Blame: Victims, Perpetrators, and Responsibility. Cambridge: Harvard University Press, Internal or external attribution is also made with re- 1996. spect to other people (i.e., is another person personally McLaughlin, Mary L., Michael J. Cody, and Stephen Reed, responsible for a certain event, or is it caused by some- eds. Explaining Oneself to Others: Reason-Giving in a thing beyond his or her control?). We make this sort of Social Context. Hillsdale, NJ: Lawrence Erlbaum Assoc., attribution when we decide whether or not to blame a 1992. friend for failing to pay back a loan. If we blame it on her personal qualities, the attribution is internal. If we blame it on a problem she is having, then the attribution is external. Three factors influence whether the behavior of others is attributed to internal or external causes: con- Authoritarian personality sensus, consistency, and distinctiveness. Consensus A personality pattern described in detail in the refers to whether other people exhibit similar behavior; 1950 book of the same name that grew out of a consistency refers to whether the behavior occurs repeat- study of anti-Semitism. Adolf Hitler and his troops. Authoritarian personality types project their own weaknesses onto groups they denigrate as inferior. (Reproduced with permission.) GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 59

Theodor Adorno (1903-1969) led a team of re- The occurrence of autism is four times higher in Autism searchers at the University of California, Berkeley, to de- boys than girls. It is now believed that some of the termine whether there was a correlation between anti- own may have been autistic children abandoned by their Semitism and certain personality traits. While the origi- “wild” or “feral” children found living outdoors on their nal goal had been the identification of an “anti-Semitic” parents. The most famous of these was Victor, the “wild personality, the scope was widened, first from anti-Se- boy of Aveyron,” discovered in 1799 at the age of ap- mitic to “Fascist” then to “authoritarian,” when the study proximately 11. Although he remained almost totally un- found that people prejudiced against one ethnic or racial able to speak, Victor showed great improvements in so- group were likely to be prejudiced against others as well. cialization and cognitive ability after working for sever- al years with Jean-Marc-Gaspard Itard, a physician and A major determining factor in the formation of the teacher of the deaf. authoritarian personality was found to be a pattern of strict and rigid parenting, in which obedience is instilled Contrary to earlier beliefs, autism is not thought to through physical punishment and harsh verbal disci- have psychological origins, such as inadequate parenting. pline. Little parental praise or affection is shown, inde- Several possible causes of autism have been proposed, in- pendence is discouraged, and the child’s behavior is ex- cluding phenylketonuria (an inherited metabolic disease), pected to meet a set standard. Significantly, such parents exposure to rubella or certain chemicals in utero, and instill in children not only obedience to themselves but hereditary predisposition. There is no accurate test for also a deeply entrenched sense of social hierarchy which autism, although CT scans of autistic children sometimes entails obedience to all persons of higher status. When reveal abnormalities in the ventricles of the brain. they reach adulthood, people with this personality struc- Autism is usually diagnosed in children between the ages ture discharge the hostility accumulated by their harsh of two and three years based on clinical observation and upbringing against those whom they perceive to be of parental reports. Until this point, manifestations of the lower status by forming negative stereotypes of them and disorder are difficult to detect, and in some cases an autis- discriminating against or overtly persecuting them. It is tic child will develop normally for the first year or two of also thought that they may be projecting their own weak- life. However, a break usually occurs before the age of nesses and fears onto the groups they denigrate as inferi- two and a half, when speech development (if it has or. Other traits associated with this personality type in- begun) stops and social responses fail to develop. clude dependence on authority and rigid rules, conformi- Children and adults with autism demonstrate a ty to group values, admiration of powerful figures, com- marked impairment in social interaction. Generally, it pulsiveness, concreteness, and intolerance of ambiguity. first appears in children as an inability to form a close attachment to their parents. As infants, they may refuse Further Reading to cuddle and may react to physical contact by stiffening Eiser, J. Richard Social Psychology: Attitudes, Cognition, and their bodies and attempting to slide away. Often, autistic Social Behaviour. New York: Cambridge University Press, 1986. children do not develop other feelings that commonly ac- Stone, William F., Gerda Lederer, and Richard Christie, eds. company emotional attachments, such as grief, sadness, Strength and Weakness: the Authoritarian Personality guilt, or shame, and when older, they are generally im- Today. New York: Springer-Verlag, 1993. pervious to being left with strangers. There is also a lack of interest in or a failure to form peer relationships, and the ordinary desire to share experiences and interests with others tends to be lacking. Autistic children lack in- Autism terest and skill in games and other typical kinds of recip- rocal child’s play, including imitative play. Standard A severe psychological disorder that first appears in nonverbal behaviors that support social interactions— early childhood and is characterized by impaired social interaction and language development, and eye contact, facial expressions, and body language—are other behavioral problems. generally not used appropriately. Language difficulties are the single symptom that First described by Dr. Leo Kanner in 1943, autism is most often leads parents to seek diagnosis and help for a severe psychological disorder that affects an estimat- autistic children. The development of spoken language is ed four children in 10,000. Autism manifests itself in either delayed or totally absent in children with autism. early childhood. The autistic child is impaired socially, Those who can speak still have trouble listening to oth- in language development, and exhibits other behavioral ers and initiating or carrying on a conversation. The problems. This disorder is also known as infantile or speech of autistic persons often lacks normal grammati- childhood autism and Kanner’s autism. cal structures and is also nonstandard in terms of such 60 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

characteristics as pitch, speed, rhythm, or stress on sylla- Frith, Uta. Autism: Explaining the Enigma. Basil Blackwell, 1989. bles. Echolalia (echoing other people’s voices or voices Jordan, Rita. Understanding and Teaching Children with heard on television) is also common. Autism. New York: Wiley, 1995. Besides social and language impairments, the other Further Information major symptom of autism is the presence of repetitive, Autism Society of America (formerly National Society for Autonomic nervous system ritualized patterns of behavior. These may be repeated Autistic Children). 7910 Woodmont Avenue, Suite 650, physical movements, such as rocking, swaying, flapping Bethesda, MD 20814-3015, (301) 657–0881, (800) one’s arms, or clapping. Autistic behavior may also take 3328–8476. such forms as arranging objects in specific patterns or quantities, mimicking a particular action, or performing a routine activity exactly the same way every day. Other behavioral characteristics associated with autism are a Autoeroticism preoccupation with a single interest (often one for which Manual stimulation (usually self-stimulation) of the a large number of facts may be collected); resistance to genital organs with the intention, typically, of pro- trivial changes in routine; fascination with a moving ob- ducing sexual arousal and orgasm. ject (such as revolving doors) or a particular part of an object; and a strong attachment to an inanimate object. Autoeroticism is the scientific term used to describe Persons with autism may exhibit oversensitivity to certain masturbation, the stimulation of the genital organs to stimuli (such as light or touch), unusual pickiness in eat- achieve orgasm. Although masturbation was widely con- ing, inappropriate fear and/or fearlessness, and self-injur- demned in most premodern societies, and has been the ing behavior, such as head banging. As many as 25 per- subject of remarkable and persistent superstitions and ex- cent of autistic children develop epileptic seizures later in treme taboos, there is evidence that contemporary atti- life, often in adolescence, although this particular symp- tudes toward masturbation are becoming increasingly tol- tom appears only in those who are mentally retarded. erant of this behavior. Studies in the United States and Europe indicate that about 90 percent of adolescent and Three-fourths of autistic children are mentally re- adult males and about 80 percent of adolescent and adult tarded, and 60 percent have IQ scores below 50. Howev- females have engaged in masturbation. While masturba- er, many demonstrate skill in music, mathematics, long- tion is usually a private, solitary activity, it is often ac- term memorization of trivial data, and specialized tasks companied by fantasies of sexual activity that involve an- such as assembling jigsaw puzzles. Autistic children other person. Relatively few individuals consistently pre- with IQ scores of 70 and above have the best prognosis fer masturbation to sexual activity that involves another for living and working independently as adults, although person. It has been shown that masturbation is not physi- only one in six children with autism becomes a well-ad- cally harmful, and the psychological significance of mas- justed adult, with another one out of six achieving a fair turbation depends on how it is regarded by the individual. degree of adjustment. Even those autistic adults who function relatively well will still experience difficulty Further Reading with social interaction and communication, and highly Marcus, Irwin M., and John J. Francis, eds. Masturbation: restricted interests and activities. Besides IQ, other pre- From Infancy to Senescence. New York: International dictors of future adjustment for autistic children are their Universities Press, 1975. degree of language development, the overall severity of their symptoms, and the types of treatment they receive. While psychotherapy has not been of value in treating persons with autism, behavior modification, medica- Autonomic nervous system tion, and dietary recommendations have been proven ef- fective in controlling specific symptoms. Special educa- The nervous system responsible for regulating auto- tion programs are able to improve the social interaction matic bodily processes, such as breathing and heart rate. The autonomic system also involves the of autistic children and enhance their academic skills. processes of metabolism, or the storage and expen- Developmental work that includes parents has been diture of energy. found to be especially helpful. Further Reading The nervous system consists of two main struc- tures, the central nervous system (the brain and the Autism: Nature, Diagnosis, and Treatment. New York: Guilford Press, 1989. spinal cord) and the peripheral nervous system (the sense Cunninghame, Karen. Autism: A World Apart. Fanlight Pro- organs and the nerves linking the sense organs, muscles, ductions, 1988. and glands to the central nervous system). The structures GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 61

behaviors one wants to eliminate by associating Aversive conditioning of the peripheral nervous system are further subdivided unpleasant stimulus while engaging in the targeted be- them with physical or psychological discomfort. into the autonomic nervous system (automatic bodily processes) and the somatic nervous system. In aversive conditioning, the client is exposed to an The part of the autonomic nervous system that con- trols the storage of energy (called anabolism) is the havior, the goal being to create an aversion to it. In parasympathetic division. Parasympathetic (or anabolic) activities involve bodily functions that occur in normal, dictions such as smoking or alcoholism. One common nonstressful situations. For example, after eating, the di- method is the administration of a nausea-producing drug gestive process begins, whereby nutrients are taken from adults, aversive conditioning is often used to combat ad- the food and stored in the body. The flow of blood in- while the client is smoking or drinking so that unpleasant creases to the stomach and intestines while at the same associations are paired with the addictive behavior. In time the heart rate decreases and saliva is secreted. The addition to smoking and alcoholism, aversive therapy parasympathetic division also mediates sexual arousal, has also been used to treat nail biting, sex addiction, and even though most parasympathetic functions lead to other strong habits or addictions. In the past, electrocon- lower overt arousal levels. Sexual climax is controlled by vulsive therapy was sometimes administered as a form the sympathetic division. of aversion therapy for certain disorders, but this practice has been discontinued. In general, sympathetic processes reverse parasym- pathetic responses. The sympathetic division is activated In children aversive conditioning plays a role in when the body mobilizes for defense or in response to one of the most effective treatments for enuresis stress. Such processes use energy stored during an- (bedwetting): the bell and pad method. A pad with a abolism; this use of energy is referred to as catabolism. wetness sensor is placed in the child’s bed, connected In defensive situations, the heart rate increases, the lungs to a bell that sounds at the first sign of wetness. When expand to hold more oxygen, the pupils dilate, and blood the bell rings, the child must then get out of bed and flows to the muscles. go to the bathroom instead of continuing to wet the While the autonomic nervous system normally func- bed. This method is successful in part because it as- tions quite appropriately, abnormalities can appear. In sociates bedwetting with the unpleasantness of being anxiety disorders, for example, certain somatic (bodily) awakened and inconvenienced in the middle of the symptoms such as muscular tension, hyperventilation, in- night. A related technique that further reinforces the creased heart rate, and high blood pressure are increased, inconvenience of bedwetting is having the child posing the body for attack. This physiological response change his own sheets and pajamas when he wakes can lead to such additional maladies as headaches and di- up wet at night. gestive problems. At times, parasympathetic responses In a variation of aversive conditioning called covert occur simultaneously. In extreme stressful situations, for sensitization, the client imagines the undesirable behav- example, an individual may experience involuntary dis- ior instead of actually engaging in it, and then either charge of the bladder and bowels. Some research has also imagines or is exposed to an unpleasant stimulus. indicated deficiencies in autonomic arousal processes in psychiatric patients prior to schizophrenic breakdown. See also Behavior therapy For decades, scientists believed that autonomic processes were not amenable to voluntary control. In re- Further Reading cent years, however, people with heart problems have Doft, Norma. When Your Child Needs Help: A Parent’s Guide learned to modify heart rates, and headache sufferers to Therapy for Children. New York: Crown Paperbacks, have learned to modify blood flow to relieve pain 1992. through biofeedback techniques. Feindler, Eva L., and Grace R. Kalfus, eds. Adolescent Behav- ior Therapy Handbook. New York: Springer, 1990. Further Reading Biofeedback and Behavioral Medicine. New York: Aldine Pub. Further Information Co., published annually since 1981. American Academy of Child and Adolescent Psychiatry. 3615 Wisconsin Avenue NW., Washington, DC 20016–3007, (202) 966–7300, (800) 333–7636. Association for the Advancement of Behavior Therapy. 15 W. Aversive conditioning 36th St., New York, NY 10018, (212) 647–1890. Also referred to as aversion therapy, a technique Federation of Families for Children’s Mental Health. 1021 used in behavior therapy to reduce the appeal of Prince St., Alexandria, VA 22314–2971, (703) 684–7710. 62 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

of social, genetic, and biological factors. Avoidant per- Avoidance learning sonality traits typically appear in childhood,with the appearance of excessive shyness and fear of new people An individual’s response to avoid an unpleasant or stressful situation; also known as escape learning. and situations. However, these characteristics are also Avoidant personality developmentally appropriate emotions for children, and do not necessarily mean that a pattern of avoidant per- Avoidance learning is the process by which an indi- sonality disorder will continue into adulthood. When vidual learns a behavior or response to avoid a stressful or shyness, unfounded fear of rejection, hypersensitivity to unpleasant situation. The behavior is to avoid, or to re- criticism, and a pattern of social avoidance persists and move oneself from, the situation. Researchers have found intensifies through adolescence and young adulthood, avoidance behavior challenging to explain, since the re- avoidant personality disorder is often indicated. Between inforcement for the behavior is to not experience the 0.5% and 1.0% of the general population suffers from negative reinforcer, or punishment. In other words, the avoidant personality disorder. reinforcement is the absence of punishment. To explain this, psychologists have proposed two stages of learning: in stage one, the learner experiences classical condition- Diagnosis ing; a warning, or stimulus, paired with a punishment. Many individuals experience avoidant personality The learner develops a fear response when he experi- characteristics at one point or another in their lives. The ences the stimulus. In stage two, the learner experiences occasional feelings of self-doubt and fear in new and un- operant conditioning; whereby he realizes that an action familiar social or personal relationships is not unusual, response to the stimulus eliminates the stressful outcome. nor is it unhealthy, as these situations may cause feelings In a common laboratory experiment conducted to of inadequacy and social avoidance in even the most demonstrate avoidance learning, a rat is placed in a con- self-confident individuals. Avoidant personality traits fined space with an electrified floor. A warning signal is only emerge as a disorder when they begin to have a given, followed by an electric current passing through long-term, negative impact on the individual, cause func- the floor. To avoid being shocked, the rat must find an tional impairment by significantly altering lifestyle and escape, such as a pole to climb or a barrier to jump over impacting quality of life, and trigger feelings of distress onto a nonelectric floor. At first, the rat responds only for the individual. when the shock begins, but as the pattern is repeated, the The Diagnostic and Statistical Manual of Mental rat learns to avoid the shock by responding to the warn- Disorders, Fourth Edition (DSM-IV), the standard diag- ing signal. An example of avoidance learning in humans nostic reference for mental health professionals in the is the situation when a person avoids a yard where there United States, states that at least four of the following is a barking dog. This learning is particularly strong in criteria (or symptoms) must be present in an individual individuals who have been attacked by a dog. for a diagnosis of avoidant personality disorder: See also Drive reduction theory; Stress • The avoidance of occupational or school activities that Further Reading involve significant interpersonal contact due to an un- Archer, Trevor, and Lars-Gvran Nilsson. Aversion, Avoidance, reasonable or excessive fear of rejection or criticism. and Anxiety: Perspective on Aversively Motivated Behav- • An unwillingness to enter into an interpersonal rela- ior. Hillsdale, NJ: L. Erlbaum Associates, 1989. tionship unless there are assurances of acceptance. Ruben, Douglas H. Avoidance Syndrome: Doing Things Out of •Restraint in interpersonal situations because of an un- Fear. St. Louis, MO: W.H. Green, 1993. reasonable fear of being ridiculed. •Preoccupation with criticism and the possibility of re- jection in social situations. Avoidant personality • Inhibition with others in interpersonal relationships due to feelings of inadequacy. A disorder characterized by the avoidance of both social situations and close interpersonal relation- •Self-perception of social inadequacy and inferiority to ships due to an excessive fear of rejection by others. others. • Reluctance to participate in new activities or take any personal risks because of a perceived risk of embarrass- Causes and symptoms ment. The cause of avoidant personality disorder is not Avoidant personality disorder can occur in conjunc- clearly defined, and may be influenced by a combination tion with other social phobias, mood and anxiety disor- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 63

Avoidant personality ders, and personality disorders. Diagnosis may be com- sumptions by asking the patient to name friends and family who enjoy his company, or to describe past social plicated by the fact that avoidant personality disorder can encounters that were fulfilling to him. By showing the either be the cause or result of other mood and anxiety dis- patient that others value his company and that social sit- orders. For example, individuals who suffer from major uations can be enjoyable, the irrationality of his social depressive disorder may begin to withdraw from social situations and experience feelings of worthlessness, symp- fears and insecurities are exposed. This process is known toms that are also prominent features of avoidant person- ality disorder. On the other hand, the insecurity and isola- tion that are symptoms of avoidant personality disorder as cognitive restructuring. can naturally trigger feelings of depression. Paula Ford-Martin Treatment Further Reading American Psychiatric Association. Diagnostic and Statistical Cognitive therapy may be helpful in treating indi- Manual of Mental Disorders 4th ed. Washington, DC: viduals with avoidant personality disorder. This therapy American Psychiatric Press, Inc., 1994. assumes that the patient’s faulty thinking is causing the personality disorder, and therefore focuses on changing Further Information distorted cognitive patterns by examining the validity of National Mental Health Association. 1021 Prince Street, the assumptions behind them. If a patient feels he is infe- Alexandria, VA, USA. 22314-2971, fax: (703)684-5968, rior to his peers, unlikable, and socially unacceptable, a (703)684-7722, (800)969-NMHA. Email: cognitive therapist would test the reality of these as- [email protected]. http://www.nmha.org. 64 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

B Albert Bandura 1925- American psychologist whose work is concentrated in the area of social learning theory. Albert Bandura was born in the province of Alberta, Canada, and received his B.A. from the University of British Columbia. He earned his M.A. and Ph.D. in clin- ical psychology at the University of Iowa, focusing on social learning theories in his studies with Kenneth Spence and Robert Sears. Graduating in 1952, Bandura completed a one-year internship at the Wichita Guidance Center before accepting an appointment to the depart- ment of psychology at Stanford University, where he has remained throughout his career. In opposition to more radical behaviorists, Bandura considers cognitive factors as causal agents in human behavior. His area of research, social cognitive theory, is concerned with the interaction between cognition, behavior, and the environment. Much of Bandura’s work has focused on the ac- quisition and modification of personality traits in children, particularly as they are affected by observa- tional learning, or modeling, which, he argues, plays a highly significant role in the determination of subse- Albert Bandura (Archives of the History of American quent behavior. While it is common knowledge that Psychology. Reproduced with permission.) children learn by imitating others, little formal re- search was done on this subject before Neal Miller and John Dollard published Social Learning and Imitation to the behaviorist learning methods of Ivan Pavlov in 1941. Bandura has been the single figure most re- and B.F. Skinner, with their focus on learning through sponsible for building a solid empirical foundation for conditioning and reinforcement. However, it has been the concept of learning through modeling, or imita- demonstrated that punishment and reward can have an tion. His work, focusing particularly on the nature of effect on the modeling situation. A child will more aggression, suggests that modeling plays a highly sig- readily imitate a model who is being rewarded for an nificant role in determining thoughts, feelings, and be- act than one who is being punished. Thus, the child havior. Bandura claims that practically anything that can learn without actually being rewarded or punished can be learned by direct experience can also be learned himself—a concept known as vicarious learning. Sim- by modeling. Moreover, learning by modeling will ilarly, Bandura has shown that when a model is ex- occur although neither the observer nor the model is posed to stimuli intended to have a conditioning effect, rewarded for performing a particular action, in contrast a person who simply observes this process, even with- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 65

Battered child syndrome out participating in it directly, will tend to become abuse, sexual acting out, running away, suicide, and be- coming abusive themselves. Dissociative identity disor- conditioned by the stimuli as well. der, popularly known as multiple personality, is also Based on his research, Bandura has developed mod- common among abused children. eling as a therapeutic device. The patient is encouraged Detecting and preventing battered child syndrome is to modify his or her behavior by identifying with and im- difficult because society and the courts have traditionally itating the behavior of the therapist. Although modeling left the family alone. Out of fear and guilt, victims rarely was first studied in relation to children, it has been found to be effective in treating phobias in adults as well. The under the age of one and therefore unable to report what patient watches a model in contact with a feared object, is happening to them. The parents or guardians who bring at first under relatively non-threatening conditions. The report abuse. Nearly one-half of child abuse victims are patient is encouraged to perform the same actions as the a battered child to a hospital emergency room rarely model, and the situation is gradually made more threat- admit that abuse has occurred. Instead, they offer compli- ening until the patient is able to confront the feared ob- cated, often obscure, explanations of how the child hurt ject or experience on his or her own. himself. However, a growing body of scientific literature on pediatric injuries is simplifying the process of differ- Bandura has also focused on the human capacity for entiating between intentional and accidental injuries. For symbolization, which can be considered a type of inverse instance, a 1991 study found that a child needs to fall modeling. Using their symbolic capacities, people con- from a height of 10 ft (3m) or more to sustain the life- struct internal models of the world which provide an threatening injuries that accompany physical abuse. Med- arena for planning, problem-solving, and reflection and ical professionals have also learned to recognize a spiral can even facilitate communication with others. Another pattern on x rays of broken bones, indicating that the in- area of social cognition theory explored by Bandura is jury was the result of twisting a child’s limb. self-regulatory activity, or the ways in which internal standards affect motivation and actions. He has studied Once diagnosed, the treatment for battered children is the effects of beliefs people have about themselves on based on their age and the potential for the parents or their thoughts, choices, motivation levels, perseverance, guardians to benefit from therapy. The more amenable the and susceptibility to stress and depression. Bandura is parents are to entering therapy themselves, the more likely the author of many books, including Adolescent Aggres- the child is to remain in the home. For infants, the treat- sion (1959), Social Learning and Personality (1963), ment ranges from direct intervention and hospital care to Principles of Behavior Modification (1969), Aggression foster care to home monitoring by a social service worker (1973), Social Learning Theory (1977), and Social Foun- or visiting nurse. Ongoing medical assessment is recom- dations of Thought and Action (1985). mended in all types of treatment. For the preschool child, treatment usually takes place outside the home, whether in See also Modeling a day care situation, a therapeutic preschool, or through individual therapy. The treatment includes speech and lan- Further Reading Decker, Philip J. Behavior Modeling Training. New York: guage therapy, physical therapy, play therapy, behavior Praeger, 1985. modification, and specialized medical care. By the time the child enters school, the physical signs of abuse are less visible. Because these children may not yet realize that their lives are different from those of other children, very few will report that their Battered child syndrome mothers or fathers are subjecting them to gross physical injury. It is at this stage that psychiatric and behavioral A group of physical and mental symptoms arising from long-term physical violence against a child. disorders begin to surface. In most cases the children are removed from the home, at least initially. The treatment, administered through either group or individual therapy, Battered child syndrome occurs as the result of focuses on establishing trust, restoring self-esteem,ex- long-term physical violence against a child or adoles- pressing emotions, and improving cognitive and prob- cent. An estimated 2,000 children die each year in the lem-solving skills. United States from confirmed cases of physical abuse and 14,000 more are seriously injured. The battering Recognizing and treating physical abuse in the ado- takes many forms, including lacerations, bruises, burns, lescent is by far the most difficult. By now the teen is an and internal injuries. In addition to the physical harm in- expert at hiding bruises. Instead, teachers and health care flicted, battered children are at risk for an array of be- professionals should be wary of exaggerated responses to havioral problems, including school difficulties, drug being touched, provocative actions, extreme aggressive- 66 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

ness or withdrawal, assaulting behavior, fear of adults, Nancy Bayley was a pioneer in the field of human self-destruction, inability to form good peer relationships, development. She devoted her life to documenting and alertness to danger, and/or frequent mood swings. Detec- measuring intellectual and motor development in infants, Nancy Bayley tion is exacerbated by the fact that all teenagers exhibit children, and adults. Her studies of the rates of physical some of these signs at one time or another. and mental maturation have greatly influenced our un- derstanding of developmental processes. Her “Bayley Abused teens do not evoke as much sympathy as Scales of Mental and Motor Development” are used younger victims, for society assumes that they are old throughout the world as standardized measurements of enough to protect themselves or seek help on their own. infant development. Bayley was the recipient of numer- In truth, all teenagers need adult guidance. The behavior ous honors and awards throughout her career. In 1966, that the abused adolescent often engages in—delinquen- she became the first woman to win the Distinguished cy, running away, and failure in school—usually evokes Scientific Contribution Award of the American Psycho- anger in adults but should be recognized as symptoms of logical Association (APA). underlying problems. The abused teen is often resistant to therapy, which may take the form of individual psy- The third of five children of Prudence Cooper and chotherapy, group therapy, or residential treatment. Frederick W. Bayley, Nancy Bayley was born in The Dalles, Oregon, in 1899. She and her siblings were deliv- While reporting child abuse is essential, false accu- ered by her aunt who had become a country physician sations can also cause great harm. It is a good idea for after her husband died. Bayley’s father was head of the anyone who suspects that a child is being physically grocery in a department store in The Dalles. Childhood abused to seek confirmation from another adult, prefer- illness prevented Bayley from attending school until she ably a non-relative but one who is familiar with the fami- was eight, but she quickly made up the missed grades ly. If the second observer concurs, the local child protec- and completed high school in The Dalles. tive services agency should be contacted. The agency has the authority to verify reports of child abuse and make decisions about protection and intervention. Defines her niche in developmental Unlike many other medical conditions, child abuse psychology is preventable. Family support programs can provide Although she entered the University of Washington parenting information and training, develop family in Seattle with plans to become an English teacher, Bay- skills, offer social support, and provide psychotherapeu- ley quickly switched to psychology after taking an intro- tic assistance before abuse occurs. ductory course with E. R. Guthrie. She earned her B.S. See also Child abuse degree in 1922 and her M.S. degree two years later, while serving as a research assistant at the Gatzert Foun- Mary McNulty dation for Child Welfare at the university. For her mas- ter’s thesis under Stevenson Smith, Bayley devised per- formance tests for preschoolers, a subject that would oc- Further Reading cupy her for the rest of her life. A graduate fellowship Ackerman, Robert J., and Dee Graham. Too Old to Cry: Abused Teens in Today’s America. Blue Ridge Summit, then took Bayley to the State University of Iowa (now PA:TAB Books, 1990. the University of Iowa) in Iowa City where she earned her doctoral degree in 1926. For her Ph.D. dissertation, Helfer, Ray E., M.D., and Ruth S. Kempe, M.D., eds. The Battered Child. Chicago: The University of Chicago Press, 1987. Bayley used the newly invented galvanometer to mea- Arbetter, Sandra. “Family Violence: When We Hurt the Ones sure electrical skin responses to fear in children. It was We Love,” Current Health 22, November 1995, p. 6. one of the first studies of its kind. Further Information In 1926, as an instructor at the University of National Committee for Prevention of Child Abuse. 332 S. Wyoming, Bayley published the first of her nearly 200 Michigan Avenue, Chicago, IL 60605, (312) 663-3520. contributions to the literature of psychology. Two years later, Harold Jones invited her to become a research as- sociate at the Institute of Child Welfare (now the Insti- tute of Human Development) at the University of Cali- fornia at Berkeley. Bayley was to remain there for most Nancy Bayley of her career. At Berkeley she met John R. Reid, a doc- 1899-1994 toral candidate in philosophy. They married in 1929, and American developmental psychologist known for Reid joined Bayley at the Institute. While at Berkeley, her “Scales of Mental and Motor Development.” Bayley taught a course on developmental assessment of GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 67

Bayley Scales of Infant Development infants and small children in the Department of Psychol- can Association for the Advancement of Science. From 1961 to 1963 Bayley served as president of the Society ogy and held concurrent research positions in psycholo- for Research in Child Development and in 1983 she gy and anatomy at Stanford University. earned their distinguished contribution award. She re- ceived the Gold Medal Award of the American Psycho- Initiates major study of infant development logical Foundation in 1982. Bayley died of respiratory failure in Carmel, California, in 1994. At the Institute, Bayley began a major study of nor- mal and handicapped infant development. It became fa- See also Bayley Scales of Infant Development mous as the Berkeley Growth Study. Her 1933 publica- tion, The California First-year Mental Scale,was fol- lowed in 1936 by The California Infant Scale of Motor Development. In these works, Bayley introduced method- ologies for assessing infant development. Likewise, her 1933 publication, Mental Growth During the First Three Further Reading Margaret Alic O’Connell, A. N. and N. F. Russo. “Models for achievement: Years, became a milestone in developmental psychology. eminent women in psychology.” Psychology of Women Bayley earned the G. Stanley Hall Award of the APA’s Di- Quarterly 5 (1980): 6-54. vision of Developmental Psychology in 1971. Lipsitt, Lewis P. and Dorothy H. Eichorn. “Nancy Bayley (1899-).” In Women in Psychology: A Bio-Bibliographic In 1954, Bayley became head of child development Sourcebook, edited by Agnes N. O’Connell and Nancy in the Laboratory of Psychology at the National Institute Felipe Russo. New York: Greenwood Press, 1990. of Mental Health in Bethesda, Maryland. There she Rosenblith, J. F. “A singular career: Nancy Bayley.” Develop- worked on the National Collaborative Perinatal Project, a mental Psychology 28 (1992): 747-58. study of 50,000 children from birth to age eight. The Stevens, G. and S. Gardner. The women of psychology. Vol. 2, study examined neurological and psychological disor- Expansion and Refinement. Cambridge, MA: Schenkman, ders, including cerebral palsy and mental retardation. 1982. The newly revised Bayley Mental and Motor Scales were used to assess the development of hundreds of chil- dren from one to eighteen months of age. Many surviv- ing subjects of this study continued to participate in fol- low-up studies. Among her many findings, Bayley Bayley Scales of Infant demonstrated that there were no sex-related differences Development in physical and mental development. She continued to work on this project after returning to Berkeley as the A comprehensive developmental test for infants and toddlers from two to 30 months of age. first head of the Harold E. Jones Child Study Center at the Institute of Human Development. She also acted as consultant on a study of infants with Down syndrome at The Bayley Scales of Infant Development measure the Sonoma State Hospital in California. mental and physical, as well as emotional and social, de- velopment. The test, which takes approximately 45 min- Bayley’s work was remarkable for its interdiscipli- utes, is administered individually by having the child re- nary nature. In 1951 she co-authored a paper with Mary spond to a series of stimuli. The Mental Scales, which Cover Jones on the relationships between physical devel- measure intellectual development, assess functions such opment and behavior. Bayley also was the first scientist as memory, learning, problem-solving ability, and verbal to correlate infant size with eventual adult size and in communication skills. The Motor Scales evaluate the 1946 she published tables for predicting adult height. child’s ability to sit and stand, perform other activities re- She was very interested in physical differences between quiring coordination of the large muscles (gross motor the sexes and in androgynous characteristics that were skills), and perform more delicate manipulations with fin- intermediate between male and female traits. She stud- gers and hands (fine motor skills). Finally, the Infant Be- ied the development of emotions in children and the havior Record (IBR) assesses the child’s social and emo- maintenance of intellectual abilities throughout adult- tional development through a standardized description of hood. Bayley also studied the impact of maternal behav- his or her behavior during the testing session. Scores are iors on children. She argued forcefully that poor devel- measured against norms for each of the 14 different age opment in children was the result of poverty and other groups. Often, the Bayley scales are used to determine social factors, rather than psychological factors. whether a child is developing normally and provide for Bayley was active in a number of professional orga- early diagnosis and intervention in cases of developmen- nizations. She was a fellow of the APA and of the Ameri- tal delay,where there is significant tardiness in acquiring 68 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

certain skills or performing key activities. Additionally, versity. During his residency in neurology he began to they can be used to qualify a child for special services investigate psychotherapy and cognition. Beck served and/or demonstrate the effectiveness of those services. as Assistant Chief of Neuropsychology at Valley Forge Aaron T. Beck Most recently, the Bayley scales have been used to insure Hospital in Pennsylvania during the Korean War compliance with legislation that requires identification of (1950–53). Even with his doubts about Freud and psy- at-risk children and provision of services for them. choanalysis, Beck attended the Philadelphia Institute of Psychoanalysis, graduating in 1958. Not long into his See also Bayley, Nancy work with patients using psychoanalysis, Beck began to Further Reading alter his approach. Beck joined the faculty of the Univer- Cohen, Libby G., and Loraine J. Spenciner. Assessment of sity of Pennsylvania (Penn) in 1954, where he began to Young Children. New York: Longman, 1994. search for empirical evidence supporting Freud’s theo- McCullough, Virginia. Testing and Your Child: What You Should ries. In his research, Beck attempted to discover a corre- Know About 150 of the Most Common Medical, Education- lation between depression and masochism. Beck and his al, and Psychological Tests. New York: Plume, 1992. colleagues failed to find this correlation. Within two Walsh, W. Bruce, and Nancy E. Betz. Tests and Assessment. years his cognitive approach to therapy had taken shape. 2nd ed. Englewood Cliffs, NJ: Prentice Hall, 1990. Beck would go on to establish the Beck Institute for Wortham, Sue Clark. Tests and Measurement in Early Childhood Cognitive Therapy and Research in Bala Cynwyd, a sub- Education. Columbus, OH: Merrill Publishing Co., 1990. urb of Philadelphia. Beck’s determination was simple. For him, the unconscious does not play the role that Freud proposed. One of Beck’s favorite maxims is “there’s more to the surface than meets the eye.” The Aaron T. Beck cognitive method involves a person using rational thoughts to overcome fears rather than delving into the 1921- American neurologist and father of cognitive therapy. unconscious causes of those fears. In cognitive therapy the fears of the client are carefully examined and con- fronted rationally. A pragmatic approach to therapy A family affair Aaron T. Beck was born in Providence, Rhode Is- Beck and his wife, Phyllis, a Superior Court Judge in land, on July 18, 1921, the third son of Russian Jewish Philadelphia, have four children and eight grandchildren. immigrants. His father was a printer by trade who seri- One of his children, Dr. Judith Beck, became director at ously abided by his socialist ideals. His rather overbear- the Beck Institute, working closely with her father. As a ing mother was known for her extreme mood swings. younger man he was driven by his work. As an older man Beck had two siblings who died before he was born. he became more driven by his family. For years his main Beck’s childhood typified middle-class America, com- supporter was his wife, at a time when his beliefs were plete with his involvement in Boy Scouts and athletics. not popular. Throughout his career he has continued to From this mediocrity rose one of America’s ground- meet his critics by encouraging them to test his theories breaking psychotherapists. Beck developed what is and his results. Rather than being a boorish scientist too known as cognitive therapy, which is used for cases smug to be proven wrong, Beck welcomes any challenges ranging from depression and panic attacks to addictions, in his pursuit of what is best for his patients. eating disorders, and even the most severe psychiatric What was originally a method to solve depression illnesses. Beck’s childhood strongly influenced his ap- has now evolved further. According to his daughter, proach to therapy. A life-threatening staph infection at Prozac and other modern anti-depressant drugs have the age of eight changed his life. At this point, Beck was changed the clientele they see at the Institute. More com- transformed from a very active young man to a quiet one plicated problems bring people to their doors at the be- who preferred reading to playing football. As a child, he ginning of the twenty-first century. These are problems developed a fear of hospitals, blood, and even the scent that might take more than the usual eight to ten sessions a of ether, which made him feel as if he would faint. Even- relatively simple case of depression would take to re- tually, he overcame those fears rationally. “I learned not solve. Beck insists that his cognitive approach can be to be concerned about the faint feeling, but just to keep used to treat psychotic disorders,even those as serious active,” he later recounted. as schizophrenia. Beck’s research conducted with Dr. Beck graduated from Brown University in 1942. In Neil A. Rector of the University of Toronto has indicated 1946 he received his Ph.D. in psychiatry from Yale Uni- that patients suffering from schizophrenia showed greater GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 69

Clifford Beers improvement through a combination of drug and cogni- tive therapies than patients receiving drug therapy alone. Beck’s theories are constantly evolving through his continued research efforts. A prolific writer, Beck has authored several books and articles both on his own as well as under collaboration. His books include Prisoners of Hate (1999), Depression: Clinical, Experimental, and Theoretical (1980), Cognitive Therapy and the Emotion- al Disorders (1979), and Depression: Causes and Treat- ment (1972). The Beck Depression Inventory and Scale for Suicide Ideation are among two of the widely used tools that he developed for use by therapists. The Beck Depression Inventory II in 1996 followed his long-suc- cessful original as an assessment tool for clinicians in di- agnosing depression. Jane Spear Further Reading Beck, Aaron T., M.D. Prisoners of Hate: The Cognitive Basis of Anger, Hostility, and Violence. New York: Harper- Collins Publishers, 1999. Goode, Erica. “A therapy modified for patient and times.” The New York Times (January 11, 2000). Goode, Erica. “Pragmatist embodies his no-nonsense therapy. Clifford Beers (AP/Wide World Photos. Reproduced with (Dr. Aaron T. Beck and his ‘cognitive therapy.’)” The New permission.) York Times (January 11, 2000). chologist and philosopher William James. After the publication of this work, and with the general support of the medical community, Beers became a leading fig- Clifford Beers ure in the movement to reform the treatment of, and at- 1876-1943 titudes toward, mental illness. In the same year his American reformer and founder of the mental hy- book was published, Beers founded the Connecticut giene movement. Society for Mental Hygiene (a name suggested by the psychologist Adolf Meyer, another supporter of Clifford Whittingham Beers was born in New Beers’s efforts). This organization lobbied for im- Haven, Connecticut, studied at Yale University, and proved treatment of mental patients and heightened began a professional career in the insurance industry. In public awareness of mental illness. In 1909, Beers or- 1900 he was institutionalized for a mental breakdown ganized the National Committee for Mental Hygiene after a suicide attempt and diagnosed as manic-depres- and served as its secretary until 1939. He also helped sive. Confined to both public and private institutions establish the American Foundation for Mental Hygiene over a three-year period, Beers found the treatment of in 1928. mental patients inhumane and ineffective. When his ef- Beers’s influence eventually spread beyond the forts to complain directly to hospital administrators United States. In 1918 he helped Clarence M. Hincks were ignored, Beers smuggled letters out to state offi- found a mental hygiene society in Canada, the Canadian cials, and his efforts met with some success. By 1903 National Committee for Mental Hygiene. Beers was ac- Beers was able to return to his career, but continued to tive in organizing the International Congress on Mental work on behalf of reforming the treatment of the men- Health in 1930, and three years later received an award tally ill. for his achievements in the mental health field from the In 1908 Beers published A Mind That Found Itself, National Institute of Social Science. Beers’s autobiogra- a popular autobiographical study of his confinement phy remained popular and influential, having gone into and recovery, which was praised by the prominent psy- 26 printings by the time of his death in 1943. 70 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

Behavior modification DID SKINNER RAISE HIS OWN CHILD IN A SKINNER BOX? A treatment approach, based on the principles of Behavior therapy operant conditioning, that replaces undesirable be- haviors with more desirable ones through positive This famous urban legend was perpetuated by a or negative reinforcement. photo that appeared in Life magazine of behavioral psy- chologist B.F. Skinner’s two-year old daughter standing up in a glass-fronted box. The box was, in fact, a cli- Behavior modification is based on the principles of mate-controlled, baby-sized room that Skinner built, operant conditioning, which were developed by Ameri- called the “aircrib.” The aircrib was made of sound-ab- can behaviorist B.F. Skinner (1904-1990). In his research, sorbing wood, had a humidifier, an air filter, and was he put a rat in a cage later known as the Skinner Box, in temperature-controlled by a thermostat. Dissatisfied which the rat could receive a food pellet by pressing on a with traditional cribs, Skinner built the box to keep his bar. The food reward acted as a reinforcement by new daughter warm, safe, and quiet without having to strengthening the rat’s bar-pressing behavior. Skinner wrap her in clothes and blankets. Skinner was quoted in studied how the rat’s behavior changed in response to dif- New Yorker magazine as saying his daughter “…spent fering patterns of reinforcement. By studying the way the most of the next two years and several months there, rats “operated on” their environment, Skinner formulat- naked and happy.” Deborah was so happy in the box, Skinner reported, that she rarely cried or got sick and ed the concept of operant conditioning, through which showed no signs of agoraphobia when removed from behavior could be shaped by reinforcement or lack of it. the aircrib or claustrophobia when placed inside. The Skinner considered his discovery applicable to a wide box-like structure and people’s misunderstandings about range of both human and animal behaviors and intro- behavioral psychology contributed to the misconception duced operant conditioning to the general public in his that Skinner was experimenting on his daughter and also 1938 book, The Behavior of Organisms. probably prevented the crib from becoming a commer- Today, behavior modification is used to treat a variety cial success. People got the impression that Skinner was raising his child in a box similar to the kind he used to of problems in both adults and children. Behavior modifi- study animal behavior—with levers for releasing food. cation has been successfully used to treat obsessive-com- pulsive disorder (OCD), attention deficit/hyperactivity disorder (ADHD), phobias, enuresis (bedwetting), anxi- ety disorder, and separation anxiety disorder, among oth- ers. One behavior modification technique that is widely Behavior therapy used is positive reinforcement, which encourages certain behaviors through a system of rewards. In behavior ther- A goal-oriented, therapeutic approach that treats emotional and behavioral disorders as maladaptive apy, it is common for the therapist to draw up a contract learned responses that can be replaced by healthier with the client setting out the terms of the reward system. ones with appropriate training. In addition to rewarding desirable behavior, behav- ior modification can also discourage unwanted behavior, In contrast to the psychoanalytic method of Sig- through either negative reinforcement, or punishment. mund Freud (1856-1939), which focuses on uncon- In children, this could be removal of television privi- scious mental processes and their roots in the past, be- leges. The removal of reinforcement altogether is called havior therapy focuses on observable behavior and its extinction. Extinction eliminates the incentive for un- modification in the present. Behavior therapy was devel- wanted behavior by withholding the expected response. oped during the 1950s by researchers and therapists criti- A widespread parenting technique based on extinction is cal of the psychodynamic treatment methods that pre- the time-out, in which a child is separated from the vailed at the time. It drew on a variety of theoretical group when he or she misbehaves. This technique re- work, including the classical conditioning principles of moves the expected reward of parental attention. the Russian physiologist Ivan Pavlov (1849-1936), who See also Behaviorism became famous for experiments in which dogs were trained to salivate at the sound of a bell, and the work of Further Reading American B.F. Skinner (1904-1990), who pioneered the Martin, Garry. Behavior Modification: What It Is and How to concept of operant conditioning, in which behavior is Do It. Englewood Cliffs, NJ: Prentice-Hall, 1988. modified by changing the response it elicits. By the Further Information 1970s, behavior therapy enjoyed widespread popularity Association for the Advancement of Behavior Therapy. 15 W. as a treatment approach. Over the past two decades, the 36th St., New York, NY 10018, (212) 279–7970. attention of behavior therapists has focused increasingly GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 71

Behaviorism on their clients’ cognitive processes, and many therapists some cases, the client practices the behavior together with a model, who is often the therapist. have begun to use cognitive behavior therapy to change clients’ unhealthy behavior by replacing negative or self- Further Reading defeating thought patterns with more positive ones. Behavior Therapy with Children and Adults: A Develop- As an initial step in many types of behavioral thera- Ammerman, Robert T. and Michel Hersen, eds. Handbook of py, the client monitors his or her own behavior carefully, mental and Longitudinal Perspective. New York: Allyn often keeping a written record. The client and therapist and Bacon, 1993. establish a set of specific goals that will result in gradual Craighead, Linda W. Cognitive and Behavioral Interventions: behavior change. The therapist’s role is often similar to An Empirical Approach to Mental Health Problems. Boston: Allyn and Bacon, 1994. that of a coach or teacher who gives the client “home- O’Leary, K. Daniel and G. Terence Wilson. Behavior Therapy: work assignments” and provides advice and encourage- Application and Outcome. Englewood Cliffs, NJ: Pren- ment. Therapists continuously monitor and evaluate the tice-Hall, 1975. course of the treatment itself, making any necessary ad- Wolpe, Joseph. The Practice of Behavior Therapy. Tarrytown, justments to increase its effectiveness. NY: Pergamon Press, 1996. A number of specific techniques are commonly used Further Information in behavioral therapy. Human behavior is routinely moti- Association for the Advancement of Behavior Therapy. 15 W. vated and rewarded by positive reinforcement. A more 36th St., New York, NY 10018, (212) 647-1890. specialized version of this phenomenon, called systemat- ic positive reinforcement, is used by behavior-oriented therapists. Rules are established that specify particular behaviors that are to be reinforced, and a reward system is set up. With children, this sometimes takes the form of Behaviorism tokens that may be accumulated and later exchanged for A theory of human development initiated by Amer- certain privileges. Just as providing reinforcement ican educational psychologist Edward Thorndike, strengthens behaviors, withholding it weakens them. and developed by American psychologists John Eradicating undesirable behavior by deliberately with- Watson and B.F. Skinner. holding reinforcement is another popular treatment method called extinction. For example, a child who ha- Behaviorism is a psychological theory of human de- bitually shouts to attract attention may be ignored unless velopment that posits that humans can be trained, or con- he or she speaks in a conversational tone. ditioned, to respond in specific ways to specific stimuli and that given the correct stimuli, personalities and be- Aversive conditioning employs the principles of haviors of individuals, and even entire civilizations, can classical conditioning to lessen the appeal of a behavior be codified and controlled. that is difficult to change because it is either very habitu- Edward Thorndike (1874-1949) initially proposed al or temporarily rewarding. The client is exposed to an that humans and animals acquire behaviors through the unpleasant stimulus while engaged in or thinking about association of stimuli and responses. He advanced two the behavior in question. Eventually the behavior itself laws of learning to explain why behaviors occur the way becomes associated with unpleasant rather than pleasant they do: The Law of Effect specifies that any time a be- feelings. One treatment method used with alcoholics is havior is followed by a pleasant outcome, that behavior the administration of a nausea-inducing drug together is likely to recur. The Law of Exercise states that the with an alcoholic beverage to produce an aversion to the more a stimulus is connected with a response, the taste and smell of alcohol by having it become associat- stronger the link between the two. Ivan Pavlov’s (1849- ed with nausea. In counterconditioning,a maladaptive 1936) groundbreaking work on classical conditioning response is weakened by the strengthening of a response also provided an observable way to study behavior. Al- that is incompatible with it. A well-known type of coun- though most psychologists agree that neither Thorndike terconditioning is systematic desensitization, which nor Pavlov were strict behaviorists, their work paved the counteracts the anxiety connected with a particular be- way for the emergence of behaviorism. havior or situation by inducing a relaxed response to it instead. This method is often used in the treatment of The birth of modern behaviorism was championed people who are afraid of flying. Modeling, another treat- early in the 20th century by a psychologist at Johns Hop- ment method, is based on the human tendency to learn kins University named John Watson. In his 1924 book, through observation and imitation. A desired behavior is Behaviorism, Watson made the notorious claim that, performed by another person while the client watches. In given a dozen healthy infants, he could determine the 72 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

adult personalities of each one, “regardless of his talents, Westen, Drew. Is Anyone Really Normal?: Perspectives on Ab- penchants, tendencies, abilities, vocations and the race of normal Psychology. Kearneysville, WV: The Teaching his ancestors.” While making such a claim seems ridicu- Company, 1991. (Four audio cassettes and one 13-page lous today, at the time Watson was reacting to emerging booklet). Bruno Bettelheim Freudian psychoanalytical theories of development, which many people found threatening. Watson’s scheme rejected all the hidden, unconscious, and suppressed longings that Freudians attributed to behaviors and posit- Bender-Gestalt Test ed that humans respond to punishments and rewards. Be- havior that elicits positive responses is reinforced and Diagnostic assessment test to identify learning dis- ability, neurological disorders, and developmental continued, while behavior that elicits negative responses delay. is eliminated. Later, the behaviorist approach was taken up by B.F. The complete name of this test is Bender Visual Skinner (1904-1990) who deduced the evolution of Motor Gestalt Test. It is a test used with all age groups to human behavior by observing the behavior of rats in a help identify possible learning disabilities, neurological maze. Skinner even wrote a novel, Walden Two, about a disorders, mental retardation, or developmental delay. Utopian society where human behavior is governed to- Test results also provide information about specific abili- tally by self-interested decisions based on increasing ties, including motor coordination, memory, and organi- pleasure. The book increased Skinner’s renown and led zation. The test-taker is given a series of nine designs, many to believe that behaviorism could indeed produce each on a separate card, and asked to reproduce them on such a society. a blank sheet of paper. There is no time limit. The test is scored by professionals who consider a variety of fac- In the 1950s, however, the popularity of behaviorism tors, including form, shape, pattern, and orientation on began to decline. The first sustained attack on its tenets the page. was made by Noam Chomsky (1928-), a renowned lin- guist, who demonstrated that the behaviorist model sim- See also Learning disability ply could not account for the acquisition of language. Other psychologists soon began to question the role of Further Reading cognition in behavior. Lacks, Patricia. Bender Gestalt Screening for Brain Dysfunc- tion. New York: Wiley, 1984. Today, many psychologists debate the extent to which cognitive learning and behavioral learning affect the development of personality. See also Behavior modification; Behavior therapy Bestiality Further Reading See Paraphilias Donahoe, John W., and David C. Palmer. Learning and Com- plex Behavior. Boston: Allyn and Bacon, 1994. Nye, Robert D. Three Psychologies: Perspectives from Freud, Skinner, and Rogers. 4th ed. Pacific Grove, CA: Brooks/Cole Pub. Co., 1992. Rachlin, Howard. Introduction to Modern Behaviorism. 3rd ed. Bruno Bettelheim New York: Freeman, 1991. 1903-1990 Sapolsky, Robert M. Biology and Human Behavior: The Neu- Austrian-born American psychologist known for his rological Origins of Individuality. Springfield, VA: The treatment of emotionally disturbed children, partic- Teaching Company, 1996. (Four audio cassettes and one ularly autistic children. 32-page manual). Staddon, John. Behaviorism: Mind, Mechanism and Society. Bruno Bettelheim was born in Vienna in 1903. He London: Duckworth, 1993. was trained as a psychoanalyst, receiving his Ph.D. from Todd, James T., and Edward K. Morris. Modern Perspectives the University of Vienna in 1938. In the same year, the on B.F. Skinner and Contemporary Behaviorism. West- port, CT: Greenwood Press, 1995. Nazis conquered Austria, and Bettelheim was interned in Todd, James T., and Edward K. Morris. Modern Perspectives the Dachau and Buchenwald concentration camps. He on John B. Watson and Classical Behaviorism. Westport, was released in 1939 and emigrated to the United States, CT: Greenwood Press, 1994. where he first became a research associate of the Pro- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 73

Bilingualism/Bilingual education tion camp experiences. Children of the Dream (1969) an- alyzes communal childrearing methods on an Israeli kib- butz and their implications for American family life. The Uses of Enchantment (1976) argues for the importance of fairy tales in a child’s development. Bettelheim’s later books include On Learning to Read: The Child’s First Fascination with Meaning (1981) and Freud and Man’s Soul (1982). A full professor at the University of Chica- go from 1952, Bettelheim retired from both teaching and directorship of the Orthogenic School in 1973. Follow- ing the death of his wife in 1984 and after suffering a stroke in 1987, Bettelheim committed suicide in 1990. See also Adaptation; Autism Further Reading Sutton, Nina. Bettelheim, A Life and a Legacy. New York: Basic Books, 1996. Bilingualism/Bilingual education Use of a language other than English in public school classrooms. Bruno Bettelheim (AP/Wide World Photos, Inc. Reproduced with permission.) The language rights of ethnic minorities in the Unit- ed States have been a source of public controversy for gressive Education Association at the University of close to two decades. The 1970s saw record levels of im- Chicago, and then an associate professor at Rockford migration, bringing an estimated 4 million legal and 8 College from 1942 to 1944. million illegal immigrants into the country. To accom- modate this dramatic surge in the nation’s population of In 1943, Bettelheim gained widespread recognition foreign language speakers, language assistance has been for his article, “Individual and Mass Behavior in Ex- mandated on the federal, state, and local levels in areas treme Situations,” a study of human adaptability based ranging from voting and tax collection to education, so- on his concentration camp experiences. In 1944, he was cial services, disaster assistance, and consumer rights. granted a dual appointment by the University of Chicago Today Massachusetts offers driver’s license tests in 24 as assistant professor and head of the Sonia Shankman languages; residents of California can choose one of six Orthogenic School, a residential treatment center for 6 to different languages when they vote; street signs in some 14-year-old children with severe emotional problems. parts of Miami are printed in both English and Spanish; Here he successfully treated many children unresponsive and classroom instruction is taught in 115 different lan- to previous therapy, using the technique—which has guages in New York City schools. Altogether, over 300 been both lauded and criticized—of unconditionally ac- languages are spoken in the United States. As of 1990, cepting their behavior. Bettelheim was also concerned 31.8 million Americans spoke a language other than with the emotional lives and upbringing of normal chil- English at home, and the country’s population included dren, and with applying psychoanalytic principles to so- 6.7 million non-English speakers. Nationwide, one-third cial problems. of the children enrolled in urban schools speak a lan- guage other than English at home as their first language. In three decades as an author of works for both Around 2.6 million schoolchildren throughout the coun- scholarly and popular audiences, Bettelheim covered a try do not speak English at all. broad range of topics. Love Is Not Enough (1950), Tru- ants from Life (1954), and The Empty Fortress (1967) are Organized opposition to bilingualism, which collec- based on his work at the Orthogenic School. The In- tively became known as the English-Only movement, formed Heart (1960) deals with Bettelheim’s concentra- began in the 1980s. In 1980 voters in Dade County, 74 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

Florida, designated English as their official language. ered ready to switch to English. In some cases, bilingual The following year, U.S. Senator S.I. Hayakawa of Cali- teachers also help the students improve their skills in fornia introduced a constitutional amendment to make their native language. Bilingual/bicultural programs use English the country’s official language. Two influential the students’ native languages not only to teach them the English-Only lobbying groups were formed: U.S. Eng- standard curriculum but also for special classes about lish, in 1983, and English First, in 1986. In 1986, with their ethnic heritage and its history and culture. Two-way the passage of Proposition 63, English became the offi- or dual language programs enroll students from different Bilingualism/Bilingual education cial language of California. By the mid-1990s, 22 states backgrounds with the goal of having all of them become had passed similar measures. In August 1996, the U.S. bilingual, including those who speak only English. For House of Representatives, by a margin of 259-169, example, Spanish-speaking children may learn English passed a bill to make English the official language of the while their English-speaking classmates learn Spanish. federal government. (However, President Bill Clinton Critics of bilingual education (or of those methods vowed to veto the bill if it passed the Senate.) Observers that rely heavily on the students’ native languages) claim attribute the English-Only movement to backlash against that it fails to provide children with an adequate knowl- immigration and affirmative action, spurred by fear of edge of English, thus disadvantaging them academically, competition for jobs and resentment of government and they cite high dropout rates for Hispanic teenagers, spending on bilingual programs. the group most likely to have received instruction in their The government program that has drawn the most native language. They accuse school systems of continu- fire is bilingual education, which costs taxpayers an esti- ing to promote bilingual programs to protect the jobs of mated $200 million a year in federal funds and billions of bilingual educators and receive federal funding allocated dollars in state and local expenditures. Bilingual educa- for such programs. As evidence of this charge, they cite tion programs, which allow students to pursue part of barriers placed in the way of parents who try to remove their study in their first language and part in English, their children from bilingual programs. Hispanic parents were first mandated by Congress in 1968. The constitu- in New York City have claimed that their children are tionality of bilingual education was upheld in a 1974 being railroaded into bilingual programs by a system that Supreme Court ruling affirming that the city of San Fran- requires all children with Spanish surnames, as well as cisco had discriminated against 18,000 Chinese-Ameri- children of any nationality who have non-English-speak- can students by failing to make special provisions to help ing family members, to take a language proficiency them overcome the linguistic barriers they faced in exam. Children scoring in the bottom 40% are then re- school. However, the court did not specify what these quired to enroll in bilingual classes even if English is the provisions should be, and educators have evolved several primary language spoken at home. Critics of bilingual in- different methods of instruction for students with first struction also cite a 1994 New York City study that re- languages other than English. With the immersion (or ported better results for ESL instruction than for methods “sink or swim”) approach, nearly all instruction is in that taught children primarily in their native languages. English, and the students are expected to pick up the lan- In spite of the criticism it has aroused, bilingual edu- guage through intensive exposure. If the teacher is bilin- cation is strongly advocated by many educators. Defend- gual, the students may be allowed to ask questions in ers cite a 1991 study endorsed by the National Academy their native language, but the teacher is supposed to an- of Sciences stating that children who speak a foreign lan- swer them in English. The English as a Second Language guage learn English more rapidly and make better over- (ESL) approach, often used in a class where students all academic progress when they receive several years of speak more than one foreign language, takes a more grad- instruction in their native language. A later study, con- ual approach to mastering English, using it in conjunction ducted at George Mason University, tracked 42,000 chil- with the student’s first language. English-only instruction dren who had received bilingual instruction and reported may be offered, but only in some, rather than all, classes. that the highest scores on standardized tests in the The remaining methods rely more heavily on the eleventh grade were earned by those students who had student’s first language. Even though, technically, all had six years of bilingual education. Programs with two- teaching methods aimed at meeting the needs of foreign way bilingual education have had particularly impressive language speakers are considered bilingual education, results. Oyster Bilingual Elementary School in Washing- participants in debates about bilingual education often ton, D.C., (whose student body is 58% Hispanic, 26% single out the following methods as targets of praise or white, 12% black, and 4% Asian) is admiringly cited as a criticism. In Transitional Bilingual Education (TBE), model for bilingual education. Its sixth graders read at a students study English but are taught all other academic ninth-grade level and have tenth-grade-level math skills. subjects in their native languages until they are consid- Experts on both sides of the controversy agree that for GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 75

Alfred Binet any teaching method to be successful, the teaching must be done by qualified instructors equipped with adequate teaching materials in appropriately assigned classes with a reasonable ratio of students to teachers. Further Reading Chavez, Linda. Out of the Barrio: Toward a New Politics of Hispanic Assimilation. New York: Basic Books, 1991. Crawford, James. Hold Your Tongue: Bilingualism and the Pol- itics of “English-Only.” Reading, MA: Addison-Wesley Publishing Co., 1992. Harlan, Judith. Bilingualism in the United States: Conflict and Controversy. New York: Franklin Watts, 1991. Lang, Paul. The English Language Debate: One Nation, One Language! Springfield, NJ: Enslow Publishers, Inc., 1995. Porter, Rosalie Pedalino. Forked Tongue: The Politics of Bilin- gual Education. New York: Basic Books, 1990. Rodriguez, Richard. Hunger of Memory: The Education of Richard Rodriguez. New York: Bantam Books, 1983. Simon, Paul. The Tongue-Tied American: Confronting the For- eign Language Crisis. New York: Continuum, 1980. Further Information Multicultural Education, Training, and Advocacy, Inc. (META). 240A Elm Street, Suite 22, Somerville, MA 02144. National Association for Bilingual Education (NABE). Union Center Plaza, 1220 L Street NW, Suite 605, Washington, Alfred Binet DC 20005. U.S. English. 818 Connecticut Ave. NW, Suite 200, Washing- ton, DC 20006. where he devised a series of tests which he used to eval- uate the intellectual development of his two daughters. His 1903 book, L’Etude experimentale de l’intelligence, was based on his studies of them. Alfred Binet In 1905, Binet and Theodore Simon created the first intelligence test to aid the French government in estab- 1857-1911 French psychologist and founder of experimental lishing a program to provide special education for men- psychology in France and a pioneer in intelligence tally retarded children. In 1908 they revised the test, ex- testing. panding it from a single scale of measurement to a bat- tery of tests for children in different age groups, with the Alfred Binet was born in Nice, France, in 1857. focus now shifted from identifying retardation to the After studying both law and medicine in Paris, he earned general measurement of intelligence. A further test revi- a doctorate in natural science. Binet’s psychological sion in 1911 introduced the concept of mental age. In training—mostly at Jean-Martin Charcot’s neurological 1916, the American psychologist Lewis Terman used clinic at the Salpetriere Hospital—was in the area of ab- the 1908 Binet-Simon scale as the basis for the Stanford- normal psychology, particularly hysteria, and he pub- Binet Intelligence Scale, the best-known and most re- lished books on hypnosis (Le magnetisme animal, with searched intelligence test in the United States. Binet co- C.S. Fere in 1886) and suggestibility (La suggestibilite, authored Les enfants anormaux (Abnormal Children) 1900). From 1895 until his death in 1911, Binet served (1907) with Simon and published Les idees modernes as director of France’s first psychological laboratory at sur les enfants (Modern Ideas on Children) in 1909. He the Sorbonne of the University of Paris. Also in 1895, he died in Paris in 1911. established the journal L’Annee psychologique. Binet See also Intelligence quotient; Mental retardation had been interested in the psychology of—and individual differences in— intelligence since the 1880s and pub- Further Reading lished articles on emotion, memory, attention, and Wolf, Theta Holmes. Alfred Binet. Chicago: University of problem solving. In 1899 he set up a special laboratory Chicago Press, 1973. 76 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

Binocular depth cues BINOCULAR DISPARITY DEMONSTRATION Biofeedback Properties of the visual system that facilitate depth perception by the nature of messages that are sent to the brain. This simple experiment demonstrates binocular disparity. Hold a pencil about 12 inches (30 cm) from your face. With one eye closed, align the pencil with Binocular depth cues are based on the simple fact the edge of a doorway, window, or other vertical line in that a person’s eyes are located in different places. One the room. Close the eye, open the other, and observe cue, binocular disparity, refers to the fact that different the position of the pencil: it will have jumped. Binocu- optical images are produced on the retinas of both eyes lar disparity describes this phenomenon of different im- when viewing an object. By processing information ages of the pencil in each eye. about the degree of disparity between the images it re- ceives, the brain produces the impression of a single ob- ject that has depth in addition to height and width. vestigative purposes. Biofeedback has been applied with The second cue, called binocular convergence, is success to a variety of clinical problems, ranging from based on the fact that in order to project images on the migraine headaches to hypertension. retinas, the two eyes must rotate inward toward each The technique provides people with continuous in- other. The closer the perceived object is, the more they formation about physiological processes of which they must rotate, so the brain uses the information it receives are normally unaware, such as blood pressure or heart about the degree of rotation as a cue to interpret the dis- rate. Through special equipment, these processes are tance of the perceived objects. Yet another cue to depth recorded, and the information is relayed back to the per- perception is called binocular accommodation, a term son through a changing tone or meter reading. With that refers to the fact that the lens of the eye changes practice, people learn strategies that enable them to shape when it brings an image into focus on the retina. achieve voluntary control over the processes involved. The muscular activity necessary for this accommodation For example, persons trying to control their blood pres- acts as a signal for the brain to generate perception of sure levels may see a light flash whenever the pressure depth and distance. drops below a certain level. They may then try to remem- See also Vision ber and analyze what their thoughts or emotions were at that moment and deliberately repeat them to keep the Further Reading pressure level low. Initially, they may simply be asked to Bennett, Jill. Sight. Morristown, NJ: SilverBurdett, 1986. try and keep the light flashing for as long as possible and Chalkley, Thomas. Your Eyes. 3rd ed. Springfield, IL: C.C. given verbal reinforcement for their efforts. Thomas, 1995. Elkins, James. The Object Stares Back: On the Nature of See- The biofeedback training may continue for several ing. New York: Simon & Schuster, 1996. days or weeks, with the subjects trying to keep the light flashing for longer periods in subsequent sessions. Even- tually they will need to produce the desired response without electronic feedback, a goal which can be accom- Biofeedback plished through various methods. They may practice the learned response at the end of the training session or at A technique that allows individuals to monitor their own physiological processes so they can learn home between sessions. There can also be random trials to control them. without feedback during the sessions. An alternate strate- gy is the gradual and systematic removal of the feedback signal during the training sessions over a period of time. Biofeedback originated with the field of psy- After the initial training is completed, subjects may re- chophysiology, which measures physiological responses turn to the biofeedback facility to assess their retention as a way of studying human behavior. Types of behavior of the skills they have learned or for additional training. that may be studied in this way range from basic emo- tional responses to higher cognitive functions. Today, Biofeedback training has been used in treating a biofeedback is also associated with behavioral medicine, number of different clinical problems. Monitoring of pa- which combines behavioral and biomedical science in tients’ heart rates has been used with some success to both clinical and research settings. In biofeedback train- help people suffering from heartbeat irregularities, in- ing, the monitoring of physiological responses is per- cluding premature ventricular contractions (PVCs) and formed for therapeutic instead of (or in addition to) in- tachycardia, while hypertensive individuals have been GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 77

Another type of biofeedback involves the monitor- Bipolar disorder ing of brain activity through electroencephalographs (EEGs). A reduction of seizures in epileptics has been reported through biofeedback techniques involving EEG activity near the sensorimotor cortex, known as sensory motor rhythm. Brain wave activity has also been of inter- est in connection with alpha waves, which are thought to characterize a desirable state of relaxed alertness. Pa- tients have been taught to increase their alpha rhythms in three or four 30-minute conditioning sessions. Further Reading Andreassi, John L. Psychophysiology: Human Behavior and Physiological Response. New York: Oxford University Press, 1980. Beatty, J., and H. Legewie, eds. Biofeedback and Behavior. New York: Plenum Press, 1977. A patient undergoing biofeedback. (Photo by Will & Deni McIntyre. Photo Researchers, Inc. Reproduced with permission.) Bipolar disorder A condition (traditionally called manic depression) able to control high blood pressure through the use of in which a person alternates between the two emo- biofeedback. Clinicians have been particularly success- tional extremes of depression and mania (an elat- ful in their use of neuromuscular feedback to treat com- ed, euphoric mood). plaints arising from tension in specific muscles or mus- cle groups. Tension headaches have been alleviated Bipolar disorder is classified among affective disor- through the reduction of frontalis (forehead) tension, and ders in the American Psychiatric Association’s Diag- relaxation of the face and neck muscles has been helpful nostic and Statistical Manual of Mental Disorders . The to stutterers. Feedback from muscle groups has been National Institute of Mental Health (NIMH) estimates helpful in the rehabilitation of stroke patients and other that about one in one hundred people will develop the persons with neuromuscular disorders such as foot drop. disorder, which affects some two million Americans. These patients may be unable to relax or contract mus- While this condition occurs equally in both males and fe- cles at will, and biofeedback can make them aware of males and in every ethnic and racial groups, it is more small, otherwise imperceptible changes in the desired di- common among well-educated, middle- and upper-in- rection and allow them to repeat and eventually increase come persons. Those suffering from untreated bipolar such changes. disorder will generally experience an average of four de- pression/ mania episodes in a ten-year period. However, In addition to its alleviation of physical complaints, some people go through four or more mood swings a neuromuscular biofeedback has been an effective tool in month, while others may only experience a mood swing the treatment of chronic anxiety, even when it has resist- every five years. The onset of bipolar disorder usually ed psychotherapy and medication. By learning deep occurs in the teens or early twenties. muscle relaxation, anxious patients, including those suf- fering from related conditions such as insomnia, have Of all types of depressive illness, bipolar disorder is seen a reduction in their symptoms. Even for patients the one that is most likely to have biological origins, who have been able to achieve relaxation through other specifically an imbalance in the brain’s chemistry. Ge- means, such as meditation or progressive relaxation, netic factors play an important role in the disease. In one biofeedback can be a valuable supplementary technique study, one-fourth of the children who had one manic-de- that offers special advantages, such as allowing a thera- pressive parent became manic-depressive themselves, pist to track closely the points at which a patient tenses and three-fourths of those with two manic-depressive up and try to learn what thoughts are associated with the parents developed the disorder. The likelihood of bipolar tension. Biofeedback-induced relaxation of forehead disorder being shared by identical twins is also excep- muscles has also been effective in treating asthma. tionally high. Manic depression has also been associated 78 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

with the “biological clock” that synchronizes body resist remaining on medication, however, either because rhythms and external events. they fear of becoming dependent on the drug or because they are reluctant to give up the “highs” or alleged cre- Birth order The depressed state of a person suffering from bipo- ativity of the manic state. However, psychiatrists have re- lar disorder resembles major depression. It is character- ported instances in which lithium was not as effective ized by feelings of sadness, apathy, and loss of energy. after being discontinued as it had been initially. Other possible symptoms include sleep disturbances; significant changes in appetite or weight; languid move- Many great artists, writers, musicians, and other ments; feelings of worthlessness or inappropriate guilt; people prominent in both creative and other fields have lack of concentration; and preoccupation with death or suffered from bipolar disorder, including composers suicide. When they shift to a manic state, people with Robert Schumann and Gustav Mahler, painter Vincent bipolar disorder become elated and overly talkative, van Gogh, writers Virginia Woolf and Sylvia Plath, and speaking loudly and rapidly and abruptly switching from actresses Patty Duke and Kristy McNichol. The NIMH one topic to another. Plunging into many work, social, or reports that 38 percent of all Pulitzer Prize-winning academic activities at once, they are in constant motion poets have had the symptoms of bipolar disorder. and are hyperactive. They also demonstrate grandiosity— an exaggerated sense of their own powers, which leads Further Reading them to believe they can do things beyond the power of Duke, Patty. Call Me Anna. New York: Bantam, 1987. Jamison, Kay. Touched with Fire: Manic-Depressive Illness and ordinary persons. Other common symptoms include ex- the Artistic Temperament. New York: Free Press, 1993. cessive and/or promiscuous sexual behavior and out-of- control shopping sprees in which large amounts of money are spent on unnecessary items. People in a manic phase typically become irritable or angry when others try to tone down their ideas or behavior, or when Birth order they have difficulty carrying out all the activities they A chronological sequence of the birth of children have begun. Mania may also be accompanied by delu- in a family. sions and hallucinations. Mania creates enormous turmoil in the lives of its Research has correlated birth order with such as- victims, many of whom turn to drugs or alcohol as a way pects of life as temperament and behavior. For example, of coping with the anxiety generated by their condi- first-born children, when compared to their siblings, tend tion—61 percent of persons with bipolar disorder have to score slightly higher on intelligence tests and to attain substance abuse or dependency problems. In addition, 15 a slightly higher socioeconomic status. Some psycholo- percent of those who fail to receive adequate treatment gists believe that birth order is a significant factor in the for bipolar disorder commit suicide. The disease may be development of personality. misdiagnosed as schizophrenia, unipolar depression, a The psychologist Alfred Adler pioneered a study of personality disorder, or drug or alcohol dependence. In- relationships between birth order and personality. As part dividuals commonly suffer from it for as long as seven to of his view that patients need to be understood in the con- ten years without being diagnosed or treated. text of their family environments, Adler hypothesized that However, effective treatment is available. Lithium, a child’s position in the family is associated with certain which stabilizes the brain chemicals involved in mood problems that are responded to in similar ways by other swings, is used to treat both the mania and depression of children in the same birth position. Adler stressed that it bipolar disorder. This drug, which is taken by millions of was not the numerical birth position itself that mattered people throughout the world, halts symptoms of mania in but rather the situation that tended to accompany that po- 70 percent of those who take it, usually working within sition, and the child’s reaction to it. Thus, for example, one to three weeks—sometimes within hours. Antipsy- first-born children, when compared to their siblings, tend chotic drugs or benzodiazepines (tranquilizers) may ini- to have a greater chance of developing feelings of inferi- tially be needed to treat cases of full-blown mania until ority as their focal position in the family structure is al- lithium can take effect. Persons taking lithium must have tered by the birth of a sibling. Later-born children, on the their blood levels, as well as kidney and thyroid func- other hand, tend to have stronger social skills, having had tions, monitored regularly, as there is a relatively narrow to deal with siblings throughout their lives, as opposed to gap between toxic and therapeutic levels of the drug. first-borns, who have their parents to themselves initially Since lithium also has the ability to prevent future manic and thus have their first socialization experiences with episodes, it is recommended as maintenance therapy even adults only. Later-borns, having had to compromise more after manic-depressive symptoms subside. Some persons at home, are better equipped to develop the flexibility that GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 79

Birth order SIBLING RIVALRY Sibling rivalry is a normal part of family life. All chil- dren become jealous of the love and attention that sib- child feel better by cuddling him or giving him special at- tention, including a small present to offset the gifts re- lings receive from parents and other adults. When a new ceived by the baby. The older child’s self-esteem can be baby is brought home, older children feel betrayed by bolstered by involving him in the care of newborn in their parents and become angry, directing their anger first modest ways, such as helping out when the baby is being toward the parents and later toward the intruder who is diapered or dressed, or helping push the carriage. The usurping their position. Jealousy, resentment, and compe- older child should be made to feel proud of the attain- tition are most intense between siblings spaced less than ments and responsibilities that go along with his more three years apart. Although a certain amount of sibling ri- advanced age—things the new baby can’t do yet because valry is unavoidable, there are measures that parents can he is too young. Another way to make older children feel take to reduce its severity and its potential effects on their loved and appreciated is to set aside some “quality time” children. to spend alone with each of them on a regular basis. It is also important for parents to avoid overtly comparing An older child should be prepared for a new addition their children to each other, and every effort should be to the family by having the situation explained and being made to avoid favoritism. told in advance about who will take care of her while her mother is in the hospital having the baby. The child’s regu- In general, the most stressful aspect of sibling rivalry lar routine should be disturbed as little as possible; it is is fighting. (Physical—as opposed to verbal—fights usual- preferable for the child to stay at home and under the care ly peak before the age of five). It is important for parents of the father or another close family member. If there is to not to take sides but rather to insist that the children work be a new babysitter or other caretaker unknown to the out disagreements themselves, calling for a temporary child, it is helpful for them to meet at least once in ad- “time out” for feelings to cool down, if necessary. Any vance. If sibling visits are allowed, the child should be form of parental involvement in squabbling by siblings taken to visit the mother and new baby in the hospital. can create a triangle that perpetuates hostilities. Over-in- Once the new baby is home, it is normal for an older sistence that siblings share can also be harmful: to retain child to feel hurt and resentful at seeing the attention lav- a sense of individuality, children need some boundaries ished on the newcomer by parents, other relatives, and fam- from their siblings in terms of possessions, territory, and ily friends. It is not uncommon for the emotional turmoil of activities. Furthermore, it is especially difficult for very the experience to cause disturbances in eating or sleeping. young children to share their possessions. Some children regress developmentally, temporarily losing such attainments as weaning, bowel and bladder control, or Parents should take time to praise cooperation and clear speech, in an attempt to regain lost parental attention sharing between siblings as a means of positive reinforce- by becoming babies again themselves. ment. The fact that siblings quarrel with each other does not necessarily mean that they will be inconsiderate, hos- There are a number of ways to ease the unavoidable tile, or aggressive in their dealings with others outside the jealousy of children whose lives have been disrupted by family. The security of family often makes children feel the arrival of a younger sibling. When friends or relatives free to express feelings and impulses they are unable to visit to see the new baby, parents can make the older in other settings. can make their subsequent relationships more successful. equal the number of second- and third-borns combined. It has also been posited that birth order influences one’s Separate studies have found high academic achievement choice of a marriage partner. The “duplication hypothe- levels among first-borns in both urban ghettoes in the sis” advanced by Walter Toman (1976) states that people United States and at British universities. First-born chil- seek to duplicate their sibling relationships in marriage, a dren are generally responsible, assertive, and task-orient- duplication that includes birth order. ed, often rising to leadership positions as adults. They are more frequently mentioned in Who’s Who publica- More specific research on the effects of birth order tions than individuals in any other birth position and are has generally focused on five ordinal birth positions: overrepresented among members of Congress and U.S. first-born, second-born, middle, last, and only-born child presidents. Studies have also found that first-born stu- in a family. Studies have consistently linked first-born dents are especially vulnerable to stress and tend to seek children and academic achievement. The number of first- the approval of others. Adler found that there were more born National Merit Scholarship winners was found to first-borns than later-borns among problem children. 80 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

Second-born and/or middle children tend to feel infe- In psychoanalytical theory, birth trauma is the first rior to the older child or children, since they do not realize major occasion of great anxiety in the life of an individ- Birth that their lower level of achievement is a function of age. ual experienced at birth as the infant moves from the They often try to succeed in areas not excelled in by their gentle comfort of the womb into a new environment full elder siblings. Middle-born children have shown a relative- of harsh and unfamiliar stimuli. While most psychoana- ly high level of success in team sports, and both they and lytical psychologists assign a moderate degree of impor- last-borns have been found to be better adjusted emotional- tance to the birth trauma in terms of its effects, some be- ly if from large families. Studies have also found middle lieve that the birth trauma is the prototypical basis of all children to be sensitive to injustice and likely to have aes- later anxiety neuroses. The universality of the birth expe- thetic interests. Generally trusting, accepting, and other- rience presents obvious difficulties in the precise deter- centered, they tend to maintain relationships successfully. mination of the nature and effects of the birth trauma. The term birth trauma may also mean any physical in- The last-born child, never dethroned as the “baby” of jury to an infant that occurs during birth. the family, often exhibit a strong sense of security and non- competitiveness. As a group, last-borns are most successful Further Reading socially and have the highest self-esteem levels of all the Hotchner, Tracy. Pregnancy and Childbirth: The Complete birth positions. One study found last-borns more likely than Guide for a New Life. 2nd ed. New York: Avon, 1990 first-borns or only children to join a fraternity or sorority. Martin, Margaret. The Illustrated Book of Pregnancy and Like youngest children, only children are never displaced as Childbirth. New York: Facts on File, 1991. the youngest in the family. With only adult models to emu- late within the family, only children are achievement-orient- ed and most likely to attain academic success and attend college. However, studies show that only children have the most problems with close relationships and the lowest need Birth for affiliation. They are also the most likely to be referred for help with psychiatric disorders. In humans, the process of delivering a child from the uterus, usually by passage through the birth Sibling rivalry frequently erupts in households with canal at the end of pregnancy, normally after a ges- two or more children, competing for the time, attention tation period of about 267 days; also called parturi- and affection of parents. The ages of children, and the tion, or labor. years between them, can influence the degree and inten- sity of of fighting and arguing. First borns may resent re- Childbearing is often viewed as the transition to sponsibility placed upon them for their siblings. Middle adult female sexuality. Birth labor is divided into several children may feel “squeezed out” while last-borns may stages. During the latent phase (Stage 0), which lasts play on their baby position in the family. Mental health from several hours to as long as three days, uterine con- experts advise parents to listen to their children’s feel- tractions (either regular or irregular) are present, but the ings rather than deny their feelings or convince them to cervix has not dilated more than three or four centime- feel differently. To lessen the tensions, experts suggest ters. The mucus plug may be passed at this stage. The that parents find time to spend with each child and share first stage of labor begins with uterine contractions ac- in each child’s interests. companied by mild pain at intervals of about 10 to 20 minutes and sensations of discomfort in the small of the Further Reading back which eventually become stronger and spread to the Leman, Kevin. The New Birth Order Book: Why You Are the entire abdominal area. The cervix, or neck of the uterus, Way You Are. Grand Rapids, Mich.: F.H. Revell, 1998. dilates rapidly from three or four centimeters until its Toman, Walter. Family Constellation: Its Effects on Personality opening is large enough to allow the passage of the child and Social Behavior. New York: Springer Pub. Co., 1993 (10 centimeters). By the end of the first stage (although Wallace, Meri. Birth Order Blues: How Parents Can Help Their Children Meet the Challenges of Birth Order. New sometimes much earlier), the sac containing the amniotic York: H. Holt, 1999. fluid which surrounds the child breaks. The first stage can take up to 12 hours with first-time mothers, although it may be very rapid in women who have had several children. It can last many hours in obstructed labor, where the baby is unusually large or badly angled. Birth trauma The second stage of labor begins with the complete In psychoanalysis, birth provides the first experi- dilation and effacement (thinning) of the cervix and ends ence of anxiety in an individual’s life. when the baby is born. At this stage, the contractions are GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 81

Birth Baby emerging from the womb. (SIU, National Audubon Society Collection/ Photo Researchers, Inc. Reproduced with permission.) increasingly frequent and intense, ultimately recurring at occurs within the first hour after the child is born, pla- intervals of two to three minutes and lasting about a cental material, or afterbirth, is expelled through the minute. The mother begins contracting her abdominal birth canal by strong uterine contractions called after- muscles voluntarily (“bearing down”), and the baby is birth pains. These contractions also help the uterus to re- expelled, usually head first, by a combination of this vol- turn to its normal size. The doctor examines the placenta untary contraction and the involuntary contractions of and amniotic sac to confirm that all tissue has been ex- the uterine muscles. The physician aids in the delivery pelled from the uterus, as serious complications may re- by guiding the infant’s head and shoulders out of the sult if fragments remain inside, especially hemorrhaging. birth canal. About 2 to 3 percent of babies are born feet If parts of the placenta or sac are missing, the doctor re- first (breech babies). Obstetrical forceps may be applied moves them by hand. Finally, the episiotomy (if one has during the second stage of labor to speed delivery in been performed) is sutured with absorbable stitches. The order to ease either maternal exhaustion or infant dis- total duration of labor averages about 13 hours for first tress. Other medical techniques utilized include the epi- deliveries and about eight hours for subsequent deliver- siotomy, a surgical incision along the back of the vagina ies, although there are large individual variances from to enlarge the opening. (This procedure is now per- these figures. formed less frequently than it was in the past.) The pain of the birth process can be relieved by When the baby is born, mucus and blood are re- drugs, but many of these drugs also have the effect of moved from the nose and mouth by means of suctioning. slowing uterine contractions or depressing the respirato- The umbilical cord is clamped and cut, and the child is ry system of the child. Drugs are either not used—or given to the mother to hold. The infant’s physical condi- used with special care—in the case of twins or prema- tion is then assessed by the Apgar score, which evalu- ture infants. Moderate doses of narcotic analgesics may ates the overall level of health based on heart rate, skin be given to the mother, which are metabolized quickly color, muscular activity and respiratory effort, and re- and nearly absent by the time of delivery. Local anesthet- sponse to stimuli. During the third stage of labor, which ics similar to Novocaine may be administered to provide 82 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

pain relief in the cervical and vaginal areas, offering tremely low. Premature labor, which occurs in about one more localized relief with fewer side effects than nar- pregnancy out of 20, is the primary danger to mother and Birth cotics. Methods of childbirth have been developed in child during the last trimester of pregnancy and the major which the use of drugs is kept to a minimum. cause of newborn death. About 40 to 50 percent of moth- ers—especially first-time mothers—experience mild post- The natural childbirth movement begun by Fernand partum depression,thought to be caused by a combina- Lamaze, which advocates birth without drugs or medical tion of biochemical factors and adjustment to the pres- intervention, departed from the practices of the 1940s sures and demands of parenthood. A smaller percentage— and 1950s, when the administration of drugs and med- between 5 and 10 percent—become severely depressed. ical procedures such as episiotomies were standard ob- Postpartum depression usually lasts up to 90 days. stetrical procedure. Natural childbirth methods use non- medical relaxation techniques for pain control and allow Abnormalities present at the time of birth, known as for more active participation in labor by the mother and a birth defects or congenital defects, occur in one of every lay coach, usually the husband. They typically include 14 babies born in the United States. More than 3,000 prenatal classes for the mother and coach. Women who birth defects have been identified, ranging from minor use the Lamaze method are taught to perform three ac- dark sports or a birthmarks to serious disfigurements or tivities simultaneously during contractions: breathing in limited lifespans. Congenital heart defects occur to one of a special pattern, chanting a nonsense or meaningless every 125 to 150 infants born in the U.S., making heart phrase coordinated with the rhythm of her breathing, and defects among the most common birth defects and the staring intently at an object. leading cause of birth defect-related deaths. Down syn- drome is the most frequently occurring chromosomal ab- The home delivery movement, which became popu- normality, occurring to one of every 800 to 1,000 infants lar in the United States during the 1970s, gave way to the born in the United States. Annually, care of children with establishment of birthing centers (in or affiliated with birth defects in the U.S. costs billions of dollars. hospitals) staffed by nurse-midwives and obstetricians in an attempt to duplicate the family-centered, drug-free Birth defects have two causes: heredity and envi- experience of home birth but without the risks posed by ronment. Environment includes maternal illness, such as the absence of medical professionals. The natural child- German measles. Other environmental factors include: al- birth movement has also focused on easing the birth ex- cohol and drugs, consumed during the pregnancy, and ex- perience for the infant. In Birth Without Violence, the posure to certain medicines or chemicals. Heavy alcohol physician Frederick Leboyer described modern hospital consumption during pregnancy can trigger fetal alcohol birth as “torture of the innocent” and proposed measures syndrome in newborns, characterized by underweight, to make the transition to life outside the womb a more small eyes, a short upturned nose with a broad bridge, gentle one for the newborn. These measures include dim and often a degree of mental retardation. Thalidomide, lights and a quiet atmosphere in the delivery room, post- prescribed in the 1950s as a mild sedative, led to the birth poning cutting of the umbilical cord, and bathing the in- of 7,000 severely deformed babies, suffering from a con- fant in lukewarm water. Psychologists Otto Rank and dition called phocomelia, characterized by extremely R.D. Laing have elaborated on the idea of birth trauma short limbs that were often without fingers or toes. as a factor in adult mental and emotional problems, and For some diseases, like spina bifida, the causes are Leonard Orr developed rebirthing in the 1970s as a unknown but believed to be a combination of heredity holistic healing technique for eliminating negative be- and environment. Spina bifida, a neural tube defect, is liefs that influence an adult’s behavior and attitudes. the most frequently occurring permanently disabling Occasionally, complicating factors that can affect the birth defect in the United States, affecting one out of mother, the child, or both are encountered in the birth every 1,000 newborns. In spina bifida, the spine fails to process. These factors include, for example, poor health, close properly during the first month of pregnancy. In anatomical abnormalities, prematurity, and unusual orien- worst cases, the spinal cord protrudes through the back. tation of the child in the uterus, such as breech presenta- A large percentage of children born with spina bifida tion, in which the child moves through the birth canal have hydrocephalus, an accumulation of fluid in the head last, and (rarely) transverse presentation, in which brain which requires a surgical procedures called the child is positioned sideways. In some women, the “shunting” to relieve the fluid build up and redirect it pelvic space is too small for spontaneous birth of a baby, into the abdominal area. Sophisticated medical tech- and the delivery of the child is accomplished through a niques allow most children with spina bifida to live well surgical opening made in the mother’s abdominal wall and into adulthood. Based on research, the U.S. Public uterus, in a procedure called a cesarean section. For a Health Service recommends that women of childbearing healthy mother and child, the risks of childbirth are ex- age in the U.S. consume 0.4 mg of folic acid daily to re- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 83

Dr. Fritz Klein, a noted psychiatrist, has expanded Bisexuality duce the risk of having a pregnancy with spinal bifida or on Kinsey’s work, creating the Klein Sexual Orientation the other two neural two defects: anencephaly or en- Grid, which takes into account seven different variables cephalocele. Amniocentesis or ultrasound testing can di- agnose spina bifida before birth. and the passage of time in defining one’s sexual orienta- tion. Klein’s variables provide a more detailed look at Sickle-cell anemia, Tay-Sachs, color blindness, one’s sexuality, examining preferences in attraction, be- deafness, and extra digits on the hand or feet are heredi- havior, fantasies, emotional involvement, social involve- tary birth defects passed on through generations by ab- ment, lifestyle, and self-identification. Klein also allows normal genes. Birth defects may not impact each genera- for sexual development over time, an important element tion, but the abnormal gene is passed on. missing from Kinsey’s work. Further Reading Martin S. Weinberg, Colin J. Williams, and Douglas Hotchner, Tracy. Pregnancy and Childbirth: The Complete W. Pryor, in their book Dual Attraction: Understanding Guide for a New Life. 2nd ed. New York: Avon, 1990. Bisexuality,have developed a simplified version of Martin, Margaret. The Illustrated Book of Pregnancy and Klein’s grid, exploring only three, rather than seven, Childbirth. New York: Facts on File, 1991. variables: sexual feelings, sexual activities, and romantic Nathaniels, Peter. Life Before Birth and a Time to Be Born. feelings. Sexual feelings include attraction, fantasies, Ithaca, NY: Promethean Press, 1992. arousal, etc. Sexual activities are actual behaviors such See also Fetal alcohol effect and syndrome as kissing, fellatio, and intercourse. Romantic feelings are the experience of “falling in love.” Self-identified bi- sexuals can be more or less hetero- or homosexual in each of these categories. Bisexuality Some studies of fraternal and identical twins show that identical twins are more likely to be bisexual than are Sexual orientation defined as sexual involvement with members of both sexes concurrently (within fraternal twins, suggesting a genetic basis for bisexual the period of one year) or any sexual attraction to predisposition. These studies have yet to be tested ade- or involvement with members of both sexes at any quately to be considered conclusive, however. The fact is time in one’s life. that without a single accepted definition of bisexuality, no single conclusion can be reached concerning its origins. There is no single accepted definition of bisexuality. Debate over why people are hetero-, homo-, or bi- Some define it narrowly as sexual involvement with mem- sexual is a fairly recent phenomenon. Identification by bers of both sexes concurrently (within a twelve-month sexual preference only began in the 19th century, and be- period or less). Others define bisexuality more broadly as fore then, it was rarely discussed. Today, however, there any sexual attraction to or involvement with members of is tremendous pressure for a person to declare a sexual both sexes at any time in one’s life. However, few people preference. The idea of bisexuality is threatening to qualify as bisexual in its narrow definition. A comprehen- some people because sexuality is no longer clearly de- sive study, “Sex in America,” conducted in 1992 by the fined between homosexuality and heterosexuality. University of Chicago, found that less than 1% of either males (0.7%) or females (0.3%) had engaged in sexual ac- Bisexuals are often accused of being “homosexuals tivity with both males and females within the previous in disguise.” As a result, they often feel confused about year. While no statistics exist on the numbers of Ameri- their sexuality. They are considered “too gay” to be cans who fit the broad definition of bisexuality, estimates straight, and “too straight” to be gay. Few resources exist range from the millions to tens of millions. to help bisexuals understand themselves. Homosexual support groups may reject them if they reveal their het- Sigmund Freud believed that bisexuality was a erosexual sides; heterosexuals may reject them if they re- “disposition” common to all humans. He contended that veal their homosexual feelings. Many bisexuals remain every individual has a masculine and feminine side, and in the closet, hiding their gender-encompassing feelings that each side is heterosexually attracted to members of from others, and sometimes even from themselves. Oth- the opposite sex. Most people, however, according to ers lead dual lives, expressing their homosexual sides Freud, repress one side, becoming either hetero- or ho- with one group of friends, while reserving their hetero- mosexual. Alfred Kinsey posited a scale for human sex- sexual selves for a totally separate social circle. uality ranging from zero, representing exclusive hetero- sexual behavior, to six, representing exclusive homosex- Life, and love, can become quite complicated for a ual behavior. Between the two poles is a spectrum of bi- bisexual person. The pressures can be tremendous, creat- sexual activity. ing a great deal of stress and pain. A 1989 U.S. Depart- 84 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

ment of Health and Human Services report determined as both the seer and the object seen. Conflict occurs that 30% of teenage suicides occur among gay and les- when the seer places unrealistic demands on him or her- bian youths, but the number of bisexual victims is un- self and the body. Body image considers physical ap- Body image known. Fortunately, however, a movement has begun in pearance and may include body functions or other fea- recent years to promote a greater acceptance and under- tures. Body image is linked to internal sensations, emo- standing of bisexuality. More studies are being done tional experiences, fantasies, feedback from others, and specifically on bisexuality or that include bisexuality as a plays a key role in a person’s self-concept. Self-percep- distinct category. tions of physical inferiority can strongly affect all areas of one’s life and may lead to avoidance of social or sexu- Unfortunately, concern over the spread of AIDS has al activities or result in eating disorders. caused another backlash against bisexuality, based on the assumption that all bisexuals are promiscuous. Most bi- How one’s physical characteristics correspond to sexuals are monogamous for all or part of their lives, and cultural standards plays a crucial role in the formation of those who engage in promiscuous behavior are not neces- body image. In the South Pacific island of Tonga, for ex- sarily at greater risk of contracting AIDS. It has been sug- ample, corpulence is considered a sign of wealth and ele- gested that of women who contract AIDS through sexual vated social status, but would be termed obesity in West- intercourse, only 10-20% were infected by bisexual males. ern societies, particularly in the United States where the slim and firm athletic form is idealized. Deference to Dianne K. Daeg de Mott cultural standards and concepts can be very damaging, as few people attain an “ideal body,” no matter how it is de- fined, and those who depart drastically from the ideal Further Reading can suffer a sharply reduced sense of self-worth. Bass, Ellen, and Kate Kaufman. Free Your Mind: The Book for Gay, Lesbian, and Bisexual Youth—and Their Allies. New Psychologists are interested in body image primarily York: HarperPerennial, 1996. to determine whether the image held reasonably agrees D’Augelli, Anthony R., and Charlotte J. Patterson. Lesbian, Gay, with reality. A seriously distorted or inappropriate body and Bisexual Identities Over the Lifespan: Psychological image characterizes a number of mental disorders. For Perspectives. New York: Oxford University Press, 1995. anorexia nervosa, a seriously distorted body image is a Ehrenreich, Barbara. “The Gap Between Gay and Straight.” classic symptom and major diagnostic criterion. The Time 141, no. 19, May 10, 1993, p. 76. anorexic, most likely an adolescent female, perceives Garber, Marjorie. Vice Versa: Bisexuality and the Eroticism of herself as “fat” even when she is emaciated. A distorted Everyday Life. New York: Simon & Schuster, 1995. Gelman, David. “Tune In, Come Out.” Newsweek 122, no. 19, sense of body image may comprise a disorder in itself, November 8, 1993, pp. 70-71. known as body dysmorphic disorder. People affected by Hutchins, Loraine, and Lani Kaahumanu, eds. Bi Any Other this condition generally become preoccupied with a spe- Name: Bisexual People Speak Out. Boston: Alyson Publi- cific body part or physical feature and exhibit signs of cations, 1991. anxiety or depression. Commonly, the victim mentally Klein, Fritz, M.D. The Bisexual Option, 2nd ed. New York: magnifies a slight flaw into a major defect, sometimes The Haworth Press, 1993. erroneously believing it the sign of a serious disease, Leland, John. “Bisexuality.” Newsweek 126, no. 3, July 17, such as cancer, and may resort to plastic surgery to re- 1995, pp. 44-50. lieve distress due to the person’s perceived appearance. Rose, Sharon, et al. Bisexual Horizons: Politics, Histories, Lives. London: Lawrence & Wishart, 1996. A healthy body image, according to some in the Weinberg, Martin S., Colin J. Williams, and Douglas W. Pryor. mental health field, is one that does not diverge too Dual Attraction: Understanding Bisexuality. New York: widely from prevailing cultural standards but leaves Oxford University Press, 1994. room for a person’s individuality and uniqueness. Humans start to recognize themselves in mirrors in meaningful ways at about 18 months and begin perceiv- ing themselves as physical beings in toddlerhood. By Body image school-age, children often face prejudices based on their The subjective conception of one’s own body, appearances. Children spend much of their early lives in based largely on evaluative judgments about how schools, an environment that is highly social and com- one is perceived by others. petitive with notoriously rigid hierarchies often based on physical appearances. Studies have found that teachers Humans have the unique ability to form abstract are also drawn to the most attractive children, which can conceptions about themselves and to gaze at themselves further compound a child’s poor body image. In a GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 85

Bonding Bonding The process by which parents form a close person- al relationship with their newborn child. Bonding is the process by which parents form a close personal relationship with their newborn child. The term “bonding” is often used interchangeably with “ at- tachment,” a related phenomenon. For the purposes of this essay, bonding is confined to the newborn period. Attachment develops over the larger period of infancy and is treated in a separate entry. The way parents feel about a new child is highly subjective and emotional, and can be very difficult to measure. Some researchers in the United States and else- where have attempted to show that there is a “sensitive period” soon after birth, in which the newborn is quietly alert and interested in engaging the mother, and the mother is able to attune to the new child. It is assumed, but not proven, that if mothers are given the opportunity to interact with their infants at this time, they are most likely to become bonded to the child—to begin to re- spond to him, love him, and take care of him. Fathers who are with their partners at the birth also respond to the infant in characteristic ways immediately after birth. American pediatricians John Kennell and Marshall Klaus pioneered scientific research on bonding in the 1970s. Working with infants in a neonatal intensive care unit, they often observed that infants were often taken Constant exposure to very thin models in the media can away from their mothers immediately after birth for emer- lead to unrealistic body images. (Photo by David Karp. gency medical procedures. These babies often remained in AP/Wide World Photos. Reproduced with permission.) the nursery for several weeks before being allowed to go home with their families. Although the babies did well in school-age child, a poor body image may result in social the hospital, a troubling percentage of them seemed not to withdrawal and poor self-esteem. prosper at home, and were even victims of battering and abuse. Kennell and Klaus also noted that the mothers of As puberty nears, children become increasingly fo- these babies were often uncomfortable with them, and did cused on the appearance of their bodies. An adolescent not seem to believe that their babies had survived birth. may mature too quickly, too slowly, in a way that is unat- Even mothers who had successfully raised previous in- tractive, or in a way that makes the adolescent stand out in fants seemed to have special difficulties with their chil- the crowd. Any deviation from the ideal can result in a neg- dren that had been treated in the intensive care nursery. ative body image, and adolescents may diet or use steroids Kennell and Klaus surmised that the separation immedi- to counter a negative self-concept. As people age, most re- ately after birth interrupted some fundamental process be- vise their views of the ideal body so that they can continue tween the mother and the new baby. They experimented to feel reasonably attractive at each stage of their lives. with giving mothers of both premature and healthy full- See also Anorexia; Bulimia term babies extra contact with their infants immediately after birth and in the few days following birth. Mothers Further Reading who were allowed more access to their babies in the hos- Cash, Thomas F. What Do You See When You Look in the Mir- pital seemed to develop better rapport with their infants, to ror?: Helping Yourself to a Positive Body Image. New hold them more comfortably, smile and talk to them more. York: Bantam Books, 1995. Costin, Carolyn. Your Dieting Daughter: Is She Dying for At- Studies conducted in the 1970s making these claims tention? New York: Brunner/Mazel, 1997. have come under attack in the 1980s and 1990s. Much of 86 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

Research shows that instinctive behaviors in new mothers facilitate bonding with their infants. (Goujon/Jerrican. Photo Bonding Researchers, Inc. Reproduced with permission.) the earlier research has been difficult to duplicate, and with their newborns in this time frame often exhibit many mitigating factors in parent-child relationships characteristic behaviors, such as stroking the baby, first make the lasting effects of early bonding experience dif- with fingertips, then with the palm, looking in the baby’s ficult to pin down with scientific rigor. Nevertheless, eyes, and speaking to the baby in a high-pitched voice. bonding research brought about widespread changes in Researchers have also found physical changes in the hospital obstetrical practice in the United States. Fathers mother right after birth, such as hormonal increases trig- and family members were allowed to remain with the gered by the infant licking or sucking her nipples, and mother during labor and delivery in many cases. Mothers increased blood flow to her breasts when hearing the in- were allowed to hold their infants immediately after fant cry. Some scientists speculate that there are instinc- birth, and in many cases babies remained with their tual behaviors triggered in the mother in response to the mothers throughout their hospital stay. Bonding research infant immediately after birth that facilitate her bonding has also led to increased awareness of the natural capa- with the infant, and thus promote the infant’s survival. bilities of the infant at birth, and so has encouraged Research on the bonding process has been scruti- many others to deliver their babies without anesthesia nized. Detractors call attention to the often poor research (which depresses mother and infant responsiveness). design of early studies and reject bonding as a scientific One important factor in the parents’ ability to bond fallacy thrust on women to make them feel that they with the infant after birth is that the healthy, undrugged must react to their infants in certain prescribed fashions. newborn is often in what is called a “quiet alert” state for Some people have misinterpreted bonding to mean that 45 to 60 minutes after birth. Research has demonstrated if the early sensitive period is missed, they cannot be- that immediately after birth the newborn can see and has come successful parents. Obviously, parents can form visual preferences, can hear and will turn his head to- close attachments to infants they did not see at birth, ei- ward a spoken voice, and will move in rhythm to his ther because of medical emergencies or because their mother’s voice. Mothers and fathers allowed to interact children are adopted. Thus, early experience with the GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 87

Borderline personality newborn is only one factor in the complex relations of devaluation are the hallmark feature of borderline per- sonality disorder. Because borderline patients set up such parents to children. excessive and unrealistic expectations for others, they Despite some problems with quantifying bonding as are bound to be disappointed when their expectations a scientific phenomenon, there is a wealth of anecdotal aren’t realized. evidence on the positive effects of an after-birth bonding The term “borderline” was originally coined by psy- experience. Most hospitals are now much more sensitive to parents’ desire to be with their newborn than in the past. Parents-to-be may wish to find out their hospital’s who bordered somewhere between psychosis and neu- policies regarding the period immediately after birth. chologist Adolf Stern in the 1930s to describe patients rosis. It has also been used to describe the borderline Questions to ask may include: Will the mother be al- states of consciousness these patients sometimes feel lowed to hold the baby immediately if there is no prob- when they experience dissociative symptoms (a feeling lem? If tests are needed, can they be delayed until after of disconnection from oneself). the first hour? What family members can be present at the birth? Can family members be present at a cesarean Causes and symptoms birth? Will the baby stay in the same room with the mother or be sent to a central nursery? Some hospitals Borderline personality disorder accounts for reportedly score mothers on how well they seem to bond 30–60% of all personality disorders, and is present in with their infants, allegedly to flag potential future child approximately 2% of the general population. The disor- abuse. This in effect makes early and rapid bonding a der appears to affect women more frequently than men, test, with failure potentially criminal, and egregiously vi- and 75% of all diagnosed patients are female. olates the spirit of the hospital reform that bonding re- Adults with borderline personalities often have a search brought about. If a hospital admits to “testing” for history of significant traumas such as emotional and bonding, parents may ask if they may decline the test, or physical abuse, neglect, or the loss of a parent in child- if they can have access to the test results. Ideally, both hood. Feelings of inadequacy and self-loathing that arise the birth and the period immediately after should be han- from these situations may be key in developing the bor- dled according to the parents’ wishes. derline personality. It has also been theorized that these patients are trying to compensate for the care they were A. Woodward denied in childhood through the idealized demands they now make on themselves and on others as an adult. Further Reading In its Diagnostic and Statistical Manual of Mental Eyer, Diane E. Mother-Infant Bonding: A Scientific Fiction. Disorders, Fourth Edition (DSM-IV),a reference stan- New Haven, CT: Yale University Press, 1992. dard for mental health professionals, the American Gaskin, Ina May. Babies, Breastfeeding and Bonding. South Psychiatric Association defines borderline personality Hadley, MA: Bergin & Garvey, 1987. as a long-standing pattern of instability and impulsive Klaus, Marshall H., John H. Kennell, and Phyllis H. Klaus. behavior beginning in early adulthood. DSM-IV states Bonding: Building the Foundations of Secure Attachment that at least five of the following criteria (or symptoms) and Independence. Reading, MA: Addison-Wesley, 1995. must be present in an individual for a diagnosis of bor- derline disorder: • Frantic efforts to avoid real or perceived abandonment. •A pattern of unstable, and intense interpersonal relation- Borderline personality ships, characterized by alternating between idealization Mental illness characterized by erratic and impul- and devaluation (i.e., a “love-hate” relationship). sive self-destructive behavior and an intense fear of • Identity disturbance characterized by an extreme, per- abandonment. sistently unstable self-image and sense of self. • Impulsive behavior in at least two areas (e.g., spending, Characteristics sex, substance abuse, reckless driving, binge eating). Borderline individuals have a history of unstable in- •Recurrent suicidal behavior, gestures, or threats, or re- terpersonal relationships. They have difficulty seeing the curring acts of self-mutilation (e.g., cutting or burning “shades of gray” in the world, and view significant peo- oneself). ple in their lives as either completely flawless or ex- •Affective (mood) instability due to brief but intense tremely unfair and uncaring (a phenomena known as episodes of dysphoria (depression), irritability, or anx- splitting). These alternating feelings of idealization and iety. 88 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

• Chronic feelings of emptiness. However, their fear of abandonment, and of ending the • Inappropriate and intense anger, or difficulty control- therapy relationship, may actually cause them to discon- ling anger displayed through temper outbursts, physical tinue treatment as soon as progress is made. fights, and/or sarcasm. Psychotherapy,typically in the form of cognitive be- Borderline personality •Transient, stress-related paranoia and/or severe disso- havioral therapy, is usually the treatment of choice for bor- ciative symptoms (a separation from the subconscious, derline personalities. Dialectical behavior therapy sometimes characterized by a “dream-like” state and (DBT), a cognitive-behavioral technique, has emerged as physical symptoms such as flashbacks). an effective therapy for borderline personalities with suici- dal tendencies. The treatment focuses on giving the bor- Diagnosis derline patient self-confidence and coping tools for life outside of treatment through a combination of social skill Borderline personality disorder typically first appears training, mood awareness and meditative exercises, and in early adulthood. Although the disorder may occur in education on the disorder. Group therapy is also an op- adolescence, it may be difficult to diagnose, as “border- tion for some borderline patients, although some may feel line symptoms” such as impulsive and experimental be- threatened by the idea of “sharing” a therapist with others. haviors, insecurity, and mood swings are also common, Medication is not considered a front-line treatment developmentally appropriate occurrences at this age. choice, but may be useful in treating some symptoms of Borderline symptoms may also be the result of the disorder, and in alleviating the symptoms of mood chronic substance abuse and biologically based medical disorders that have been diagnosed in conjunction with conditions (specifically, disorders of the central nervous borderline personality disorder. Recent clinical studies system). These should be ruled out as causes before have indicated that naltrexone, an opiate antagonist, may making the diagnosis of borderline personality disorder. be helpful in relieving physical discomfort related to dis- The disorder commonly occurs together with mood sociative episodes. disorders (i.e., depression and anxiety), post-traumatic stress disorder, eating disorders, attention deficit/hy- Prognosis peractivity disorder (ADHD), and other personality disorders. It has also been suggested by some re- The disorder usually peaks in young adulthood and searchers that borderline personality disorder is not a frequently stabilizes after age 30. Approximately 75- true pathological condition in and of itself, but rather a 80% of borderline patients attempt or threaten suicide, number of overlapping personality disorders; however, it and between 8-10% are successful. If the borderline pa- is commonly recognized as a separate and distinct disor- tient suffers from depressive disorder, the risk of suicide der by the American Psychological Association and by is much higher. For this reason, swift diagnosis and ap- most mental health professionals. propriate interventions are critical. See also Dissociation/Dissociative disorders Treatment Paula Ford-Martin Individuals with borderline personality disorder seek psychiatric help and hospitalization at a much high- er rate than people with other personality disorders, Further Reading probably due to their fear of abandonment and need to American Psychiatric Association. Diagnostic and Statistical seek out idealized interpersonal relationship. These pa- Manual of Mental Disorders, 4th ed. Washington, D.C.: tients represent the highest percentage of diagnosed per- American Psychiatric Press, Inc., 1994. Moskovitz, Richard A. Lost in the Mirror: An Inside Look at sonality disorders (up to 60%). Borderline Personality Disorder. Dallas, TX: Taylor Pub- Providing effective therapy for the borderline per- lishing, 1996. sonality patient is a necessary, but difficult, challenge. The therapist-patient relationship is subject to the same Further Information BPD Central. http://www.bpdcentral.com. inappropriate and unrealistic demands that borderline National Alliance for the Mentally Ill (NAMI). 200 North personalities place on all their significant interpersonal Glebe Road, Suite 1015, Arlington, VA, USA. 22203- relationships. They are chronic “treatment seekers” who 3754, (800)950-6264. http://www.nami.org. become easily frustrated with their therapist if they feel National Institute of Mental Health (NIMH). 6001 Executive they are not receiving adequate attention or empathy, Boulevard, Rm. 8184, MSC 9663, Bethesda, MD, USA. and symptomatic anger, impulsivity, and self-destructive 20892-9663, fax: (301)443-4279, (301)443-4513. Email: behavior can impede the therapist-patient relationship. [email protected]. http://www.nimh.nih.gov. GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 89

Boredom A state of weariness with, and disinterest in, life. years of the twentieth century. was one of the leading Boredom cities for psychological research. Trained as a physician, Boss received his medical degree from the University of Zurich in 1928. Before that, however, he had spent time in Vienna, where he had met (and been analyzed by) Sig- Everyone, at one time or another, feels bored. Chil- mund Freud. dren, however, may report boredom more frequently be- It was Boss’s exposure to the writings of Ludwig cause they have not yet learned to alleviate it for them- Binswanger and Heidigger that prompted him to formu- selves. Infants and toddlers rarely experience boredom. late a psychological model. Binswanger (1881-1966) has Infants spend large blocks of time asleep and much of been called the first existential psychologist. In 1946, their waking time feeding. Toddlers have a nearly unlim- Boss met Heidigger, and it was then that he was able to ited curiosity to explore a world that is still new to them. fully grasp the concepts that led to his later work. Preschool and school-aged children, though, are fickle in their attentions. The child may be engrossed in an activ- Essentially, Boss believed that Dasein was a means ity one minute and, seconds later, lose interest and com- of opening the mind—of bringing light to a situation. plain of boredom. The symbolism of light played an important role in Boss’s work: the idea of “coming out of the darkness,” of Adults who complain of boredom may be express- “illuminating an idea,” and ultimately, of “enlighten- ing their frustration at being unchallenged by their pre- ment.” Boss further believed that mood played an impor- sent activities. People who complain about being bored tant part in how people reacted to their environment. An at work, for example, may feel that they are not being angry person, for example, would be attuned primarily to used to their potential. Boredom in adults is often a sign things that create feelings of anger. Boss also felt that of a lack of intellectual stimulation. In rare instances, dreams were important—more so than other existential people who repeatedly complain of boredom might be thinkers. What made his interpretation of dreams differ- suffering from a clinical condition such as depression. ent from those of Freud or Jung, however, was that he Depressed people may withdraw from formerly interest- believed that dreams created their own message rather ing activities and complain of boredom. Such a person than displaying symbols of deeper feelings. may need to talk to a psychologist about the factors that are causing the depression. Boss’s books include Existential Foundations of Medicine and Psychology, Psychoanalysis and Dasein- Further Reading analysis, and The Analysis of Dreams. He died in 1990. Wester-Anderson, Joan. “Overcoming Life’s Little Doldrums,” Current Health 19, (February 1993): 4+. George A. Milite Medard Boss 1903-1990 Murray Bowen Swiss psychotherapist who helped build the con- cept of existential psychology. 1913-1990 American psychiatrist who pioneered family therapy. The idea of combining psychology and philosophy may seem to run counter to the idea of psychology as a Murray Bowen grew up in a small town that he be- science. But psychology is a science of the mind, and the lieved gave him the foundation for his theories on family releationship between the mind and ideas is critically im- therapy. To Bowen, the family was an emotional unit; portant to psychological study. Medard Boss, trained as a although it was made up of individuals who had their physician, used his knowledge of philosophy to help hu- own thoughts and needs, much of how they behaved was manize psychology. He spent his career developing the the result of how they functioned as part of the family. concept he called Daseinanalysis. “Dasein” is a German Bowen, the oldest of five children, was born in Wa- word meaning “being there,” and it forms a critical ele- verly, Tennessee, on January 31, 1913. His parents were ment of the philosophy of Martin Heidigger (who be- Jesse and Maggie Bowen; their families had lived in came a friend of Boss). Tennessee since the days of the American Revolution. Boss was born in St. Gallen, Switzerland on Octo- Jesse Bowen was mayor of Waverly, and he also ran sev- ber 4, 1903 and raised in Zurich. Zurich during the early eral small businesses there, including the funeral parlor. 90 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION